title: Serum leptin and serum leptin/serum leptin receptor ratio imbalance in obese rheumatoid arthritis patients positive for anti-cyclic citrullinated peptide antibodies.
abstract: BACKGROUND
  Leptin has a prominent role in the development and maintenance of acute and chronic inflammatory states such as rheumatoid arthritis (RA) and obesity. Nevertheless, the association of serum leptin (sLep) and soluble leptin receptor (sLepR) in RA pathogenesis has not been clarified. The purpose of this study was to evaluate the association of sLep, sLepR and leptin production indexes such as sLep/fat mass ratio with clinical activity and biomarkers and anti-cyclic citrullinated peptide (anti-CCP) antibodies in RA compared with body mass index (BMI) matched control subjects.
  
  
  METHODS
  We included 64 RA patients and 66 controls matched for age, gender and BMI. Subjects were evaluated for BMI, fat mass distribution, sLep, sLepR, sLep/fat mass ratio and sLepR/fat mass ratio. Patients were evaluated for clinical activity and anti-CCP antibodies.
  
  
  RESULTS
  We found two or three fold increased sLep levels, sLep/sLepR ratio and sLep/fat mass ratio in obese anti-CCP positive RA patients vs.
  
  
  METHODS
  Partial correlations showed that anti-CCP antibodies were correlated with sLep/fat mass ratio (partial r = 0.347, P = 0.033) after adjustment for age, subcutaneous adipose tissue and fat mass.
  
  
  CONCLUSIONS
  In preobese and obese RA patients there is and increased production of sLep according to anti-CCP positivity. This phenomenon suggests there is an additive effect of chronic inflammation resulting from RA and obesity in which leptin favors the humoral response against citrullinated proteins. In summary, the data observed in our study suggests sLep could be a surrogate marker of chronicity and humoral immunity in RA in the presence of obesity.
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. reumatologo.eduardo@gmail.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gómez-Bañuelos
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. rosa_elena_n@hotmail.com.
authors.forename: Rosa Elena
authors.initials: RE
authors.lastname: Navarro-Hernández
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. fernandacoronameraz@live.com.mx.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Corona-Meraz
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. perlamadrigal@hotmail.com.
authors.forename: Perla Monserrat
authors.initials: PM
authors.lastname: Madrigal-Ruíz
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. bety_m@yahoo.com.
authors.forename: Beatríz Teresita
authors.initials: BT
authors.lastname: Martín-Marquez
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. sorrento80@hotmail.com.
authors.forename: Oscar Enrique
authors.initials: OE
authors.lastname: Pizano-Martinez
authors.affiliation: Servicio de Reumatología, División de Medicina Interna, OPD Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Zip code 44100, Guadalajara, Jalisco, >México. joraguil@hotmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Aguilar-Arreola
authors.affiliation: Servicio de Reumatología, División de Medicina Interna, OPD Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Zip code 44100, Guadalajara, Jalisco, >México. pauljacobperezcruz@outlook.com.
authors.forename: Paul Jacob
authors.initials: PJ
authors.lastname: Perez-Cruz
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. hectormaciasr@gmail.com.
authors.forename: Hector
authors.initials: H
authors.lastname: Macias-Reyes
authors.affiliation: Departamento de Medicina Interna-Reumatología, Hospital General Regional no.110, Instituto Mexicano del Seguro Social, Circunvalación Oblatos No. 2212, Colonia Oblatos, Zip code 44700, Guadalajara, Jalisco, México. dralauragonzalez@prodigy.net.mx.
authors.forename: Laura
authors.initials: L
authors.lastname: Gonzalez-Lopez
authors.affiliation: Unidad Médica de Alta Especialidad, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Belisario Domínguez No. 1000, Independencia Oriente, Zip code 44340, Guadalajara, Jalisco, México. drivangamez@prodigy.net.mx.
authors.forename: Jorge Ivan
authors.initials: JI
authors.lastname: Gamez-Nava
authors.affiliation: Unidad Médica de Alta Especialidad, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Belisario Domínguez No. 1000, Independencia Oriente, Zip code 44340, Guadalajara, Jalisco, México. msalazpa@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Salazar-Páramo
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, CUCS, Universidad de Guadalajara, Sierra Mojada No. 950, Colonia Independencia, Zip code 44340, Guadalajara, Jalisco, México. dravme@hotmail.com.|Servicio de Reumatología, División de Medicina Interna, OPD Hospital Civil de Guadalajara, "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Zip code 44100, Guadalajara, Jalisco, >México. dravme@hotmail.com.
authors.forename: Monica
authors.initials: M
authors.lastname: Vazquez-del Mercado
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002956:Citrulline / Q000097:blood*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D054411:Receptors, Leptin / Q000097:blood*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; C515448:LEPR protein, human; D020738:Leptin; D054411:Receptors, Leptin; D002956:Citrulline