Circulating Adipokines and Associations With Incident Cardiovascular Disease in Rheumatoid Arthritis.

Area of Science:

• Rheumatology
• Cardiology
• Endocrinology

Background:

• Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD).
• Adipokines, such as adiponectin, leptin, and fibroblast growth factor 21 (FGF-21), play roles in inflammation and metabolism, potentially influencing CVD risk.
• Understanding the specific roles of these adipokines in RA-related CVD is crucial for risk stratification.

Purpose of the Study:

• To investigate the association between circulating levels of adiponectin, leptin, and FGF-21 and the incidence of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA).

Main Methods:

• Serum samples from RA patients were analyzed for adipokine levels (adiponectin, leptin, FGF-21).
• Incident CVD events, including coronary artery disease (CAD), stroke, heart failure (HF) hospitalization, venous thromboembolism, and CVD-related deaths, were tracked.
• Multivariable Cox proportional hazards models were used to assess the relationship between adipokine concentrations and CVD incidence, with adjustments for relevant covariates.

Main Results:

• High adiponectin levels were independently associated with increased risk of HF hospitalization (HR 1.39) and CVD-related death (HR 1.49).
• High leptin levels were independently associated with an increased risk of CVD-related death (HR 1.44).
• High FGF-21 levels were independently associated with a reduced risk of CAD (HR 0.75).
• Associations between high adiponectin and leptin with CVD-related death were more pronounced in nonobese RA patients.

Conclusions:

• Circulating adipokines, specifically adiponectin and leptin, are associated with adverse cardiovascular outcomes, including heart failure hospitalization and CVD-related death, in patients with RA.
• The observed associations were stronger in nonobese individuals, suggesting a complex interplay between adipokines, body composition, and CVD risk in RA.
• These adipokines may serve as potential biomarkers for predicting CVD risk in RA patients, warranting further investigation to augment current risk assessment tools.