Leptin predicts RA severity | Arthritis Information

Study findings published in the journal Rheumatology International suggest that the adipocyte-secreted hormone leptin predicts the severity of rheumatoid arthritis (RA).

The progression of RA is closely linked to the production of inflammatory cytokines such as tumor necrosis factor-α, a key source of which is white adipose tissue. The anorexigenic hormone leptin is also produced by adipose tissue and animals lacking the hormone are less susceptible to the development of inflammatory disorders.

Hypothesizing, therefore, that leptin might predict the progression of RA, a team from the Medical University of Lublin in Poland, led by Bozena Targonska-Stepniak, studied leptin concentrations, nutritional status, and disease severity in 37 RA patients.

The investigators found that, although leptin levels were generally within the normal physiological range, they were significantly higher in patients with erosive RA than in those with non-erosive disease.

In addition, among those who had suffered RA for over 10 years, leptin concentrations significantly predicted disease severity, with levels significantly higher in patients with higher disease activity, as shown by a score below 5.1 on the 28 joints disease activity score system (DAS28).

Serum leptin concentrations also positively correlated with erythrocyte sedimentation rate, and the number of tender joints.

Interestingly, leptin concentration was related to body mass index but only in women.

Regarding their findings, the clinicians note that "exacerbations do occur in the course of chronic RA and are associated with excessive production of pro-inflammatory cytokines and probably leptin, which could explain higher leptin levels in the course of exacerbated disease."

Recommending further research they conclude "that some important dependence exists between the risk of aggressive course of RA and increased leptin levels."

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Lynn,
Thanks for posting all of the informative research articles. One thing from the article I still don't understand is how will you know if you have the erosive or non erosive type. I already had x-rays and will return to RD this Thurs to discuss x-rays and start meds for disease control. If the x-rays don't really show anything as I am understanding that sometimes they don't what will be next? You are very welcome. I think knowledge is power. I have x-rays done every year to track joint damage. I have erosive Ra and since starting on Rituxan I haven't experienced any more damage. I know that my left knee already has some bone spurring but I am not sure if that means erosion . My question would be this, when I return to Rd this Thurs. will she be able to let me know if I have erosive RA or not based on x-ray findings? Lynn. a question. If a person with RA does not get erosion the first few years, does that mean they may not get any at all? I'm not sure what determines erosion with people with RA. Is it a positive factor? High CRP and ESR's? What determines erosive versus non erosive?Good questions Lorster. I've read a lot recently about what are some of the predictors for outcomes in RA.

According to what I've read erosions are much more common in older patients than in younger patients. According to the study at the bottom of the page, the peak incidence of first erosions is within the first 24 months of disease, individuals who are nonerosive at 24 months have an ongoing risk of becoming erosive, which does not decline with time.

In my experience, I don't think being seronegative or being seropositive matters all that much. (I'm seronegative and I have erosive RA) I do think high CRP and ESR's play a significant role and I have some studies that back that theory up.

Functional disability scores also seem to be a strong and reliable predictor of what sort of outcome people will have with their RA. There is a lot of research that the HAQ score predicts many features of the patient's subsequent disease course, including mortality.

Here is one of the studies that I'm talking about...I must get ready for church and a family breakfast, I'll check back later.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1779379