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Circulating Adipokines and Associations With Incident Cardiovascular Disease in Rheumatoid Arthritis

Lydia E Federico1, Tate M Johnson2, Bryant R England2

  • 1University of Pennsylvania, Philadelphia.

Arthritis Care & Research
|March 21, 2022
PubMed

Insights

High levels of adiponectin and leptin are linked to increased cardiovascular disease (CVD) death in rheumatoid arthritis (RA) patients, especially nonobese individuals. Fibroblast growth factor 21 (FGF-21) showed a protective association with coronary artery disease (CAD).

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.
Abstract

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