Abstract
BackgroundPrevious research indicates a role of adipokines in inflammation and osteogenesis. Hence adipokines might also have a pathophysiological role in inflammation and new bone formation in patients with ankylosing spondylitis (AS). The aim of this study was to investigate the role of adipokine serum levels as predictors of radiographic spinal progression in patients with AS.MethodsA total of 120 patients with definite AS who completed a 2-year follow up in the ENRADAS trial were included in the current study. Radiographic spinal progression was defined as: (1) worsening of the modified Stoke Ankylosing Spondylitis spine (mSASSS) score by ≥2 points and/or (2) new syndesmophyte formation or progression of existing syndesmophytes after 2 years. Serum levels of adipokines (adiponectin (APN) and its high molecular weight form (HMW-APN), chemerin, leptin, lipocalin-2, omentin, resistin, visfatin) were measured using enzyme-linked immunosorbent assays.ResultsThere was a significant association between radiographic spinal progression and both leptin and HMW-APN. Baseline serum levels of both adipokines were lower in patients who showed radiographic spinal progression after 2 years. This association was especially evident in men; they had generally lower leptin and HMW-APN serum levels as compared to women. The inverse association between adipokines and radiographic spinal progression was confirmed in the logistic regression analysis: the odds ratios (OR) for the outcome “no mSASSS progression ≥2 points” were 1.16 (95% CI 1.03 to 1.29) and 1.17 (95% CI 0.99 to 1.38), for leptin and HMW-APN, respectively; for “no syndesmophyte formation/progression” the respective OR were 1.29 (95% CI 1.11 to 1.50) and 1.18 (95% CI 0.98 to 1.42), adjusted for the presence of syndesmophytes at baseline, C-reactive protein at baseline, sex, body mass index (BMI), non-steroidal anti-inflammatory drugs intake score over 2 years, and smoking status at baseline.ConclusionSerum leptin and HMW-APN predict protection from spinal radiographic progression in patients with AS. Women generally have higher leptin and HMW-APN serum levels that might explain why they have less structural damage in the spine as compared to male patients with AS.Trial registrationEudraCT: 2007-007637-39. ClinicalTrials.gov, NCT00715091. Registered on 14 July 2008.
Highlights
Previous research indicates a role of adipokines in inflammation and osteogenesis
It has been shown that baseline syndesmophytes [4, 5], inflammatory activity as assessed by C-reactive protein (CRP), by the Ankylosing Spondylitis Disease Activity Score (ASDAS), or by the presence of inflammatory changes on magnetic resonance imaging (MRI) [6,7,8,9,10,11,12], and cigarette smoking [13] are factors associated with more rapid radiographic spinal progression
There was an increase in the leptin level after 2 years in both treatment groups; this was statistically significant in the continuous treatment group only: increase of 13.6 ± 13.2 ng/ml to 15.6 ± 15.6 ng/mL, p = 0.002
Summary
Previous research indicates a role of adipokines in inflammation and osteogenesis. adipokines might have a pathophysiological role in inflammation and new bone formation in patients with ankylosing spondylitis (AS). Several biomarkers in the blood were found to be positively associated with new bone formation in the spine: the already mentioned CRP [7], matrix-metalloproteinase-3 [14], vascular endothelial growth factor [15], calprotectin [16], and the adipokine, visfatin [17]. Some biomarkers, such as sclerostin [18] and dickkopf 1 [19], have been associated with radiographic spinal progression, suggesting that these molecules might have a protective effect
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
