Role of Adipokine in the Cardiovascular Risk Profile among Patients with Inflammatory Arthritides

Accumulating evidence has linked the adipose tissue to whole-body homeostasis, in particular systemic inflammation. Since the discovery of leptin in 1994, more than 50 biological substances are discovered. Some of them are termed adiopokine, which involve in an array of physiologic regulation through endocrine, paracrine, autocrine or juxtacrine mechanisms of action. The most important adipokines are tumor necrosis factor (TNF), interleukin-6 (IL-6), leptin, adiponectin, visfatin, and chemerin; several of which have been found to be major regulator of insulin resistance and body energy conservation. Their close link with metabolic syndrome suggests adipokines may be important biomarkers for cardiovascular risk. RA and gout are both associated with high risk of cardiovascular diseases. However, the basic pathogenesis is still unknown. Adipokine, as a novel cytokine that is central regulator of inflammation, insulin resistance and lipid regulation, may be the link between inflammation and atherosclerosis. Although several studies have been conducted to elucidate the role of adipokine in RA and gout, many unanswered questions exist including the serum adipokine levels and comparison with levels in normal population, correlation with disease activity and the correlation between adipokine and cardiovascular risk assessment measures. In this study, we hypothesize that adipokine is the link between systemic inflammation and heightened cardiovascular risk among RA and gout patients. Therefore, we plan to investigate serum levels of various adipokines, including leptin, adiponectin, visfatin, chemerin and resistin, and the progression of atherosclerosis and endothelial dysfunction, both prerequisites for coronary heart disease and ischemic stroke. The objectives of the present study are to compare adipokine levels in patients with RA and gout to age and sex compatible cohort and to identify the role of adipokine in the cardiovascular risk profile of RA and gout. To achieve the objectives, we plan to conduct longitudinal follow-up for RA and gout patients’ adipokine levels and correlate with quantitative cardiovascular risk assessment measures, such as pulse wave velocity, pulse wave contour analysis and carotid intima media thickness, to assess the predictive power of adpipokine on the progression of cardiovascular risk measures. We’ll enroll 360 subjects with RA, gout and normal controls with a 1:1:1 ratio. These subjects will undergo 4 times of adipokine measurement. At the same time, atherosclerotic assessment will be conducted. Further, we’ll also correlate adipokine levels with arthritis activity and the influence of anti-inflammatory medical intervention.

Project ID:PC10007-1147
External Project ID:NSC100-2314-B182-029