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Adipocytokines in systemic lupus erythematosus: relationship to inflammation, insulin resistance and coronary atherosclerosis

Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USA

AG Long

Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USA

JF Solus

Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA

YH Rho

Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USA

A Oeser

Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USA

P Raggi

Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia, USA

CM Stein

Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA; Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USAmichael.stein{at}vanderbilt.edu

We tested the hypothesis that concentrations of adipocytokines are altered in SLE and associated with coronary atherosclerosis, insulin resistance and inflammation. Concentrations of resistin, leptin, adiponectin and visfatin were measured in 109 patients with SLE and 78 control subjects. Coronary calcification was measured using electron beam-computed tomography, and insulin resistance was defined by the homeostasis model assessment index. Concentrations of adiponectin (28.7 ± 17.9 vs 22.0 ± 15.3 µg/mL, P = 0.003), leptin (41.1 ± 49.9 vs 19.8 ± 24.6 ng/mL, P < 0.001) and visfatin (7.5 ± 10.5 vs 4.5 ± 2.8 ng/mL, P < 0.001) were higher in patients with SLE than in controls. These differences remained significant after adjustment for age, race, sex and body mass index (BMI; all P values < 0.02). Concentrations of resistin (10.7 ± 7.6 vs 9.1 ± 5.1 ng/mL, P = 0.41) did not differ in patients and controls. In patients with SLE, leptin was positively associated with BMI ( = 0.80, P < 0.001), insulin resistance ( = 0.46, P < 0.001) and C-reactive protein (CRP) ( = 0.30, P = 0.002), whereas adiponectin was negatively associated with the same factors ( = –0.40, P < 0.001;  = –0.38, P < 0.001;  = –0.22, P = 0.02, respectively). None of the adipocytokines were associated with coronary atherosclerosis in SLE. In conclusion, patients with SLE have increased concentrations of adiponectin, leptin and visfatin. Lower concentrations of adiponectin and higher concentrations of leptin are associated with insulin resistance, BMI and CRP in patients with SLE.

Key Words: adipocytokines • atherosclerosis • inflammation • insulin resistance • systemic lupus erythematosus

Lupus, Vol. 18, No. 9, 799-806 (2009)
DOI: 10.1177/0961203309103582


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