Article Text
Abstract
Purpose To determine the leptin and adiponectin levels in women with systemic lupus erythematosus (SLE) and clarify the relationship of adipocytokines with cardiovascular risk factors.
Materials and Methods The study included 48 women with SLE (median age 40 [31;49] years, disease duration 3 [1;9] years), mostly with low and moderate activity (SLEDAI 2K index = 5[2;8]). The majority (83%) received glucocorticoids (GC) at the time of the examination, hydroxychloroquine was taken by 75%, immunosuppressants – by 21%, biological preparations – by 10% patients. The median daily GC dose in terms of prednisone was 10 [7.5; 10] mg/day. The control group included 35 women matched in age and body mass index (BMI) with SLE patients. The levels of adipocytokines (leptin and adiponectin) were assessed by ELISA. The following cardiovascular risk factors were studied: age, smoking status, BMI, waist circumference (WC), blood pressure (BP), insulin resistance (according to Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index), hypertriglyceridemia (according to the apolipoprotein B (ApoB) levels).
Results The leptin levels in SLE were 28.4 [9.4;71.6] ng/ml, and in the control group - 13.0[7.9;16.5] ng/ml (p<0.001), the adiponectin concentrations were 9.1[5.3;10.1] µg/ml and 7.7[5.5;10.3] µg/ml, respectively (p=0.9). Leptin levels correlated with BMI (r=0.73, p<0.0001), WC (r=0.69, p<0.0001), HOMA-IR (r=0, 57, p<0.001), SLEDAI 2K (r= -0.47, p<0.001), SLICC damage index (r=0.3, p=0.04), duration of GC use (r=0.3, p =0.04). There were weak negative correlations of adiponectin levels with systolic BP (r=-0.29, p=0.04) and ApoB concentrations (r=-0.31, p=0.03). Relationships between adiponectin and BMI, SLE activity, and therapy were not found.
Conclusions In women with SLE, serum leptin levels were higher and adiponectin concentrations were similar to those in the control group. Leptin levels increased with decreased SLE activity, long-term GC use, and were associated with obesity and insulin resistance. Adiponectin, on the contrary, was independent of SLE activity, but had a favorable, although weak, effect on blood pressure and lipid profile.
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