Abstract
ObjectiveTo evaluate circulating visfatin and its relationship with disease activity and serum lipids in patients with early, treatment-naïve rheumatoid arthritis (RA).MethodsSerum visfatin was measured in 40 patients with early RA before and after three months of treatment and in 30 age- and sex-matched healthy individuals. Disease activity was assessed using the Disease Activity Score for 28 joints (DAS28) at baseline and at three and 12 months. Multivariate linear regression analysis was performed to evaluate whether improved disease activity is related to serum visfatin or a change in visfatin level.ResultsSerum visfatin was significantly elevated in early RA patients compared to healthy controls (1.92±1.17 vs. 1.36±0.93 ng/ml; p = 0.034) and significantly decreased after three months of treatment (to 0.99±0.67 ng/ml; p<0.001). Circulating visfatin and a change in visfatin level correlated with disease activity and improved disease activity over time, respectively. A decrease in visfatin after three months predicted a DAS28 improvement after 12 months. In addition, decreased serum visfatin was not associated with an improved atherogenic index but was associated with an increase in total cholesterol level.ConclusionA short-term decrease in circulating visfatin may represent an independent predictor of long-term disease activity improvement in patients with early RA.
Highlights
Visfatin was originally discovered and named pre-B-colony enhancing factor [1] but was later renamed visfatin, reflecting its predominant secretion by visceral adipose tissue [2]
Twenty patients met the criteria for highly active disease (DAS28.5.1), 18 patients had moderate disease activity (3.2,Disease Activity Score for 28 joints (DAS28)#5.1), and two patients had low disease activity (2.6,DAS28#3.2) at baseline
We have shown that an elevated visfatin level correlates with disease activity and that a decrease in visfatin level during the first three months of treatment independently predicts further disease activity improvement after 12 months in patients with treatment naıve early rheumatoid arthritis (RA)
Summary
Visfatin was originally discovered and named pre-B-colony enhancing factor [1] but was later renamed visfatin, reflecting its predominant secretion by visceral adipose tissue [2]. In RA, persistent synovial inflammation and invasive behaviour by activated synovial fibroblasts contribute to joint damage, leading to disability [8]. Some data indicate that visfatin is elevated in RA and may be associated with the degree of inflammation, clinical disease activity and radiographic joint damage [3,10,11]. These findings are not consistent throughout all studies [12,13,14]
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