Rheumatoid arthritis impacts on the independent relationships between circulating adiponectin concentrations and cardiovascular metabolic risk
Mediators of Inflammation
Cardiovascular Pathophysiology and Genomics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Melville 2109, Johannesburg 2193, South Africa; Department of Rheumatology, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, 7 York Road, Parktown, Johannesburg 2193, South Africa
Adiponectin and leptin are likely involved in the pathophysiology of rheumatoid arthritis (RA) and therefore potential new therapeutic targets. Adiponectin inhibition could be expected to enhance cardiovascular metabolic risk. However, it is unknown whether RA changes the influence of adipokines on cardiovascular metabolic risk. We determined whether RA impacts on the independent relationships of circulating leptin and adiponectin concentrations with cardiovascular risk factors and carotid intima-media thickness (cIMT) in 277 black African subjects from a developing population; 119 had RA. RA impacted on the relationships of adiponectin concentrations with lipid concentrations and blood pressure, independent of confounders including adiposity (interaction P < 0.05). This translated into an association of adiponectin concentrations with more favorable lipid variables including HDL cholesterol (P = 0.0005), non-HDL cholesterol (P = 0.007), and triglyceride (P = 0.005) concentrations, total cholesterol-HDL cholesterol (P = 0.0002) and triglycerides-HDL cholesterol (P = 0.0003) ratios, and higher systolic (P = 0.0006), diastolic (P = 0.0004), and mean blood pressure (P = 0.0007) in RA but not non-RA subjects. Leptin was not associated with metabolic risk after adjustment for adiposity. The cIMT did not differ by RA status, and adipokine concentrations were unrelated to atherosclerosis. This study suggests that leptin and adiponectin inhibition may not alter overall cardiovascular risk and disease in RA. © 2013 Patrick H. Dessein et al.
adiponectin; angiotensin receptor antagonist; antidiabetic agent; beta adrenergic receptor blocking agent; C reactive protein; calcium channel blocking agent; cholesterol; dipeptidyl carboxypeptidase inhibitor; glucose; high density lipoprotein cholesterol; hydroxymethylglutaryl coenzyme A reductase inhibitor; insulin; leptin; nonsteroid antiinflammatory agent; triacylglycerol; adipocytokine; adiponectin; high density lipoprotein cholesterol; leptin; adipocytokine; adult; alcohol consumption; antihypertensive therapy; arterial wall thickness; article; body mass; cardiometabolic risk; carotid atherosclerosis; cholesterol blood level; correlational study; diastolic blood pressure; exercise; female; glucose blood level; human; major clinical study; male; mean arterial pressure; obesity; priority journal; protein blood level; rheumatoid arthritis; risk assessment; smoking; systolic blood pressure; triacylglycerol blood level; waist circumference; waist hip ratio; aged; arterial pressure; atherosclerosis; blood; cardiovascular disease; carotid artery disease; middle aged; physiology; rheumatoid arthritis; risk factor; blood; cardiovascular disease; Adipokines; Adiponectin; Aged; Arterial Pressure; Arthritis, Rheumatoid; Atherosclerosis; Cardiovascular Diseases; Carotid Artery Diseases; Carotid Intima-Media Thickness; Cholesterol, HDL; Female; Humans; Leptin; Male; Middle Aged; Risk Factors; Adipokines; Adiponectin; Aged; Arterial Pressure; Arthritis, Rheumatoid; Atherosclerosis; Cardiovascular Diseases; Carotid Artery Diseases; Carotid Intima-Media Thickness; Cholesterol, HDL; Female; Humans; Leptin; Male; Middle Aged; Risk Factors