Added value of biomarkers compared with clinical parameters for the prediction of radiographic spinal progression in axial spondyloarthritis

Rheumatology ◽  
2019 ◽  
Vol 58 (9) ◽  
pp. 1556-1564 ◽  
Author(s):  
Judith Rademacher ◽  
Lorraine Madeline Tietz ◽  
Lien Le ◽  
Agnes Hartl ◽  
Kay-Geert A. Hermann ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Ankylosing Spondylitis ◽  
High Molecular Weight ◽  
Predictive Value ◽  
Axial Spondyloarthritis ◽  
Added Value ◽  
Clinical Parameters ◽  
High Molecular Weight Adiponectin ◽  
Clinical Model ◽  
Amyloid A

Abstract Objectives The objective of this study was to examine whether adding biomarkers to routine clinical parameters improves prediction of radiographic spinal progression in axial spondyloarthritis. Methods One hundred and seventeen patients with ankylosing spondylitis who completed the Effects of NSAIDs on RAdiographic Damage in Ankylosing Spondylitis (ENRADAS) trial were included. Radiographic spinal progression was defined as worsening of the modified Stoke Ankylosing Spondylitis Spine Score by ⩾2 points after 2 years. A clinical prediction model was constructed out of baseline syndesmophytes, elevated CRP, cigarette smoking and male sex. The following serum biomarkers were measured at baseline by ELISA: MMP3, VEGF, calprotectin, leptin, high molecular weight adiponectin, osteoprotegerin, sclerostin, N-terminal telopeptide, procollagen type II N-terminal propeptide and serum amyloid A. Results Repeated cross-validation analyses revealed one biomarker combination with potential added predictive value in addition to the clinical model: leptin + high molecular weight adiponectin + VEGF. This biomarker combination showed an area under the curve (AUC)Biomarkers = 0.731 (95% CI: 0.614, 0.848), which was numerically superior to the clinical model [AUCClinical = 0.665 (95% CI: 0.553, 0.776)]. A combination of clinical parameters + biomarkers showed an improved predictive value compared with the clinical model reflected by AUCClinical+Biomarkers = 0.768 (95% CI: 0.666, 0.871), though not statistically significant (P = 0.051). However, by considering the part of the receiver operating characteristic curve with a specificity ⩾75% resulting in partial AUC (pAUC), the improvement becomes significant (pAUCClinical+Biomarkers = 0.119; pAUCClinical = 0.053; P = 0.01). Conclusion Biomarkers show potential to improve the prediction of radiographic spinal progression in axial spondyloarthritis when used in addition to the clinical parameters, though the added value seems to be rather small.

scholarly journals Acute and Short-term Chronic Testosterone Fluctuation Effects on Glucose Homeostasis, Insulin Sensitivity, and Adiponectin: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study

2014 ◽  
Vol 99 (6) ◽  
pp. E1088-E1096 ◽  
Author(s):  
Christian Høst ◽  
Lars C. Gormsen ◽  
David M. Hougaard ◽  
Jens S. Christiansen ◽  
Steen B. Pedersen ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Glucose Metabolism ◽  
Crossover Study ◽  
High Molecular Weight ◽  
Glucose Disposal ◽  
Short Term ◽  
High Molecular Weight Adiponectin ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Total Glucose

Context: Low levels of adiponectin and T in men have been shown to predict development of the metabolic syndrome, but the effects of T on glucose metabolism are incompletely understood and may be influenced either directly or indirectly through changes in body composition or in levels of adiponectin. Objective: The aim of the study was to test whether T exerts its effects on glucose metabolism directly or indirectly. Design, Setting, and Participants: In a randomized, double-blind, placebo-controlled, crossover study, 12 healthy young males were studied on four separate occasions. They received GnRH agonist treatment 1 month before 3 of 4 trial days to induce castrate levels of T. On trial days, T gel containing either high or low physiological T dose or placebo was applied to the body. On a fourth trial day, participants constituted their own eugonadal controls. Intervention: Each study comprised a 5-hour basal period and a 3-hour hyperinsulinemic euglycemic clamp. Main Outcome Measures: We measured the effect of acute T on peripheral glucose disposal, total adiponectin and subforms, and other indices of glucose metabolism. Results: Short-term hypogonadism was associated with increased high molecular weight adiponectin levels (P < .03) and increased oxidative glucose disposal (P = .03) but not total glucose disposal (P = .07). Acute T treatment was an independent suppressor of high molecular weight adiponectin levels (P = .04) but did not affect total glucose disposal (P = .17). Conclusions: These data show that T can act through putative fast nongenomic pathways to affect adiponectin levels in humans. The early hypogonadal state is characterized by a marked shift in fuel oxidation from lipids toward glucose, which may rely partly on buffering capabilities of adiponectin.

A NovelADIPOQMutation (p.M40K) Results in Impaired High-Molecular-Weight Adiponectin and Associates with Obesity and Early-Onset Metabolic Syndrome

2011 ◽  
pp. OR38-4-OR38-4
Author(s):  
Ana Carolina Bueno ◽  
Margaret Castro ◽  
Jorge Elias Junior ◽  
Viviane Cunha Cardoso ◽  
Marco Antonio Barbieri ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Molecular Weight ◽  
High Molecular Weight ◽  
Early Onset ◽  
High Molecular Weight Adiponectin
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