Background Bone mineral density and proteins/peptides determination in blood and urine as markers of bone resorption and formation are currently used to diagnose osteoporosis (OP) and metabolic bone diseases. However, these methods have some disadvantages for bone turnover evaluation. Recent evidence suggests that in RA changes in the secretion of hormones of white adipose tissue can be revealed [1,2]. One of them is Adiponectin possessing anti-inflammatory, anti-diabetic and anti-atherogenic properties. Changes in Adiponectin levels may reflect influence of immune inflammation on bone turnover.
Objectives To study the clinical and diagnostic value of serum Adiponectin determination in RA patients complicated by OP.
Methods We examined 88 women with documented diagnosis of RA and mean disease duration of 6.56±0.88 years. We used EULAR/ARA 2010 criteria to diagnose the patients. Female patients with II degree of disease activity (DAS28), Steinbrocker stage II (erosive), rheumatoid factor- and anti-cyclic-citrullinated peptide antibody-positive were prevalent. We excluded patients who had surgery or developed an infection within the last 8 weeks, pregnant and breast-feeding women, those with severe heart, liver or kidney disease, immune deficiency, leukopenia or chronic infection.
A control group of 45 healthy females aged of 25 and 59 years were included in the study. There were no reported findings of joint pain and RA symptoms in the group. The groups were adjusted for age (p>0.05) and showed no statistically significant differences.
We measured serum Adiponectin levels (μg/ml) using Human Adiponectin ELISA commercial test systems (BioVendor, Czech Republic, cat No. RD195023100). We used spectrophotometer with wavelength of 450 nm to detect the test results (“Multiskan” immunoenzyme analyzer, Finland). We plotted a curve using computer software. We diagnosed OP using dual-energy X-ray absorptiometry with LUNAR DPX PRO (GE, USA).
Results Serum adiponectin levels in the control group were 12.5±0.9 μg/ml (M±m). Adiponectin levels in healthy subjects measured as M ±2d, ranged between 0.44 and 24.56 μg/ml. Patients with OP and RA had significantly higher levels of serum Adiponectin (p<0.001). Mean serum Adiponectin levels in RA patients who had normal bone density and had no OP were 35.21±0.6 μg/ml. Mean serum Adiponectin levels in RA/OP patients with low bone mineral density were 52.42±0.69 μg/ml. Adiponectin levels of 44 μg/ml and higher were associated with osteoporosis. Adiponectin levels of 43.9 μg/ml and lower were associated with normal bone density.
Conclusions Thus, we revealed that Adiponectin levels depend on osteoporosis presence in RA patients. We suppose that Adiponectin determination may be useful laboratory marker for OP diagnosis. The test may be used to reduce the risk of low-energy fractures and to improve the quality of life in RA.
Eliseev M.S. Revmatoidnyj artrit na Kongresse EULAR-2014 v Parizhe: novye zadachi, novye perspektivy. Revmatologija. 2014;5(16):s.2–5.
Polyakova J. V., Simakova E. S., Zavodovsky B. V., Seewordova L. E., Zborovskaya I. A. Serum visfatin determination in rheumatoid arthritis. Ann. Rheum. Dis. 2014; 73 (Suppl2).
Disclosure of Interest None declared