Adipokines and Associations With Incident Osteoporotic Fracture in Patients With Rheumatoid Arthritis

Area of Science:

• Rheumatology
• Endocrinology
• Metabolic Health

Background:

• Rheumatoid arthritis (RA) patients face increased fracture risk.
• Adipokines, signaling proteins from adipose tissue, play roles in inflammation and metabolism.
• The relationship between adipokines and fracture risk in RA is not well understood.

Purpose of the Study:

• To investigate the association between circulating adipokines and incident fractures in patients with rheumatoid arthritis (RA).

Main Methods:

• Serum levels of adiponectin, leptin, and fibroblast growth factor-21 (FGF-21) were measured in a longitudinal RA cohort.
• Adipokine levels were dichotomized using median values.
• Incident fractures were identified and confirmed, and Cox proportional hazard models were used to assess risk, adjusting for multiple covariates.

Main Results:

• In a cohort of 2527 RA patients (mean age 72 years), higher levels of leptin, FGF-21, and adiponectin were associated with increased incident fracture risk.
• Elevated leptin (HR: 1.47) and FGF-21 (HR: 1.39) significantly increased fracture risk.
• Individuals with high levels of all three adipokines had double the fracture risk (HR: 2.17) compared to those with low levels of all three.

Conclusions:

• Circulating adipokine levels are independently associated with an increased risk of incident fractures in RA patients.
• This finding suggests adipokines may contribute to bone fragility in RA, beyond traditional risk factors.
• Further research is warranted to explore the mechanisms, potentially involving body composition or metabolic pathways.