Disease-Modifying Antirheumatic Drugs Increase Serum Adiponectin Levels in Patients With Rheumatoid Arthritis

Abstract

Adiponectin is an adipocyte-derived adipokine with immunosuppressive and anti-inflammatory properties. It also decreases expression of adhesion molecules. In terms of its relationship with acute-phase reactants, there are conflicting results in patients with rheumatoid arthritis (RA). The objectives of this study were to evaluate the levels of adiponectin in RA patients before and after the treatment with disease-modifying antirheumatic drugs (DMARDs) and to evaluate whether there is a correlation between adiponectin levels and disease activity and acute-phase-response reactants (APRRs). Serum adiponectin levels, APRRs, total and high-density lipoprotein cholesterol (HDL-C), body mass index, and body fat mass were measured in 27 patients with RA before and after the treatment with DMARDs plus prednisolone. An inclusion criterion for RA patients was to be DMARD naive for at least 6 months or to have been newly diagnosed with RA. Twenty patients with osteoarthritis were included in this study as a disease control. No significant difference was found between RA and osteoarthritis group in terms of baseline adiponectin level. Mean adiponectin level and mean HDL-C level increased significantly compared with mean baseline level after the treatment with DMARDs plus prednisolone (10 [SD, 4.9] vs. 13.9 [SD, 8.7] μg/mL; P < 0.001; 56.8 [SD, 19] vs. 65 [SD, 18] mg/dL, P < 0.004, respectively). APRRs and the 28-joint-count disease activity score decreased significantly at the end of the 3 months of therapy. The adiponectin levels tended to be negatively correlated with acute-phase reactants and disease activity, although no changes were significant. There was a positive correlation between HDL-C and adiponectin levels at 3 month (r = 0.53, P < 0.001). No correlation was found between erythrocyte sedimentation rate and adiponectin levels both at baseline and at 3 months. Adiponectin levels can be modified by effective treatment of rheumatoid arthritis. This suggests that active inflammation may decrease serum adiponectin levels. In consideration of the antiatherogenic and anti-inflammatory features of adiponectin, increased adiponectin levels in patients with RA may result in a more favorable cardiovascular profile.