Clinical significance of leptin in systemic lupus erythematosus

2021 ◽  
Vol 15 (6) ◽  
pp. 61-66
Author(s):  
L. V. Kondratyeva ◽  
T. A. Panafidina ◽  
T. V. Popkova ◽  
Yu. N. Gorbunova ◽  
M. V. Cherkasova
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Overweight And Obesity ◽  
Immunoreactive Insulin ◽  
Model Assessment ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Calculated Concentration

Objective: to study the frequency of hyperleptinemia in patients with systemic lupus erythematosus (SLE), its relationship with clinical and laboratory manifestations of the disease, drug therapy, and other metabolic disorders.Patients and methods. The cross-sectional study included 46 women with a definite diagnosis of SLE (median age 40 [31; 48] years) and disease duration 3.0 [0.9; 9.0] years. Glucocorticoids (GC) were received by 38 (83%) patients, hydroxychloroquine – by 35 (76%), immunosuppressants – by 10 (22%), biologic disease-modifying antirheumatic drugs – by 5 (11%). In all patients, fasting levels of glucose, leptin, apoliproprotein B (ApoB) and immunoreactive insulin were determined, and homeostatic model assessment for insulin resistance (HOMA-IR) was calculated. Concentration of leptin ≥11.1 ng/ml, ApoB – >1.6 mg/ml were considered an elevated level. HOMA-IR index ≥2.77 corresponded to the presence of insulin resistance (IR).Results and discussion. Hyperleptinemia was found in 34 (74%) patients with SLE, an increased level of ApoB – in 19 (41%), IR – in 10 (22%). In patients with hyperleptinemia, serositis, positivity for anti-double-stranded DNA (aDNA) and hypocomplementemia were less common, overweight and obesity were more frequent, the SLEDAI-2K index was lower, the aDNA level was lower, and the concentration of the C3 component of complement, insulin, HOMA-IR index, body mass index (BMI) and disease duration were higher (p<0.05 for all cases). BMI <25 kg / m2 had 26 (57%) women, 14 (54%) of whom had hyperleptinemia. In patients with BMI <25 kg / m2, we found a relationship between leptin concentration and disease duration (r=0.4, p=0.04), SLE activity according to SLEDAI-2K (r=-0.6, p=0.003), levels of aDNA (r=-0.6, p<0.001), C3 component of complement (r=0.5, p=0.01), maximum (r=0.7, p<0.001) and supporting (r=0,5, p=0.023) GC doses.In patients with BMI ≥25 kg/m2 (n=20), no such relationship was observed.Conclusion. Hyperleptinemia was found in the majority of women with SLE; elevated levels of ApoB and IR were much less common. Patients with hyperleptinemia are characterized by a longer duration and less activity of the disease, as well as the presence of overweight and obesity and an increase in the HOMA-IR index. In SLE patients with normal body weight, the concentration of leptin increased along with GC dose elevation.

A comparative study on clinical and serological characteristics between patients with rhupus and those with systemic lupus erythematosus and rheumatoid arthritis

Lupus ◽  
2020 ◽  
Vol 29 (10) ◽  
pp. 1216-1226
Author(s):  
Beatriz Frade-Sosa ◽  
Javier Narváez ◽  
Tarek Carlos Salman-Monte ◽  
Raul Castellanos-Moreira ◽  
Vera Ortiz-Santamaria ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Classification Criteria ◽  
Systemic Lupus ◽  
Cross Sectional

Background The concomitant presence of two autoimmune diseases – systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) – in the same patient is known as rhupus. We evaluated a group of patients with rhupus to clarify further their clinical, serological and immunogenic features in a multi-centre cohort. In addition, the study aimed to explore the utility of the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in our group of patients with rhupus. Methods This was a cross-sectional study. We included rhupus patients from 11 different rheumatology departments, and compared them to SLE and RA patients at a ratio of 2:1. All information was recorded following a pre-established protocol. Results A total of 200 patients were included: 40 rhupus patients and 80 each of SLE and RA patients as controls. Disease duration was similar among SLE and rhupus groups (around 13 years), but the RA group had a significantly lower disease duration. Main clinical manifestations were articular (94.2%), cutaneous (77.5%) and haematological (72.5%). Rhupus patients had articular manifestations similar to those expected in RA. Only 10% of rhupus patients had renal involvement compared with 25% of those with SLE ( p < 0.05), while interstitial lung disease was more common in patients affected by RA. The 2019 EULAR/ACR SLE criteria were met in 92.5% of the rhupus patients and in 96.3% of the SLE cohort ( p > 0.05). Excluding the joint domain, there were no differences between the numbers of patients who met the classification criteria. Conclusion Rhupus patients follow a particular clinical course, with full expression of both SLE and RA in terms of organ involvement, except for a lower prevalence of kidney affection. The new 2019 EULAR/ACR SLE criteria are not useful for differentiating SLE and rhupus patients. A new way of classifying autoimmune diseases is needed to identify overlapping clusters.

scholarly journals Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Betsabe Contreras-Haro ◽  
Sandra Ofelia Hernandez-Gonzalez ◽  
Laura Gonzalez-Lopez ◽  
Maria Claudia Espinel-Bermudez ◽  
Leonel Garcia-Benavides ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Lupus Erythematosus ◽  
Screening Test ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Factors Associated ◽  
Tyg Index ◽  
Surrogate Index

Abstract Background Insulin resistance (IR) is frequently observed in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In clinical practice, IR assessment is limited to a low proportion of patients due to cost and equipment and technical expertise requirements. The surrogate index of triglycerides and glucose (TyG index) has been validated in non-rheumatic populations, showing adequate sensitivity and specificity for IR, although this index has not yet been used in connective tissue disorders. The aim of this study was to evaluate the frequency of insulin resistance (IR) using the validated surrogate index of triglycerides and glucose (TyG index) and to explore factors associated with IR in Mexican women with RA or SLE. Methods Ninety-five female RA and 57 SLE patients were included in a cross-sectional study. Clinical and epidemiological variables were evaluated. IR was assessed using the TyG index with a cutoff value of > 4.68. Logistic regression analysis was performed to identify factors associated with IR excluding confounders. Results IR frequency in the entire sample was 50%, higher than the 10% observed in non-rheumatic controls (p < 0.001). The frequency of IR was similar in SLE (49.1%) and RA (50.5%, p = 0.8) patients. IR was associated with a longer duration of hypertension and higher total cholesterol and low density lipoprotein cholesterol levels. Based on multivariate analysis, the duration of hypertension (OR: 1.06; 95% CI 1.002–1.12, p = 0.04), waist circumference (OR: 1.04; 95% CI 1.01–1.08, p = 0.007), uric acid levels (OR: 1.46; 95% CI 1.08–1.97, p = 0.01), RA (OR: 4.87; 95% CI 1.31–18.78, p = 0.01) and SLE (OR: 4.22; 95% CI 1.06–16.74, p = 0.04) were the main risk factors for IR. Conclusions This study shows that the TyG index is a useful screening test for IR in RA and SLE patients. Future longitudinal studies should be performed with the aim of identifying the predictive value of TyG index results for identifying complications linked to IR.

scholarly journals Resistin Levels in Lupus and Associations with Disease-specific Measures, Insulin Resistance, and Coronary Calcification

2011 ◽  
Vol 38 (11) ◽  
pp. 2369-2375 ◽  
Author(s):  
JOSHUA F. BAKER ◽  
MEGAN MORALES ◽  
MOHAMMED QATANANI ◽  
ANDREW CUCCHIARA ◽  
ELENI NACKOS ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Lupus Erythematosus ◽  
Inflammatory Markers ◽  
Damage Index ◽  
Coronary Calcification ◽  
Model Assessment ◽  
Systemic Lupus ◽  
Resistin Level ◽  
Cross Sectional ◽  
Disease Specific

Objective.To evaluate levels of resistin in female subjects with systemic lupus erythematosus (SLE) compared to age and race-matched controls and to determine the relationship between resistin and systemic inflammation, disease measures, and coronary artery calcification (CAC).Methods.Resistin levels were measured on stored samples from 159 women with SLE and 70 controls as an extension of a previous cross-sectional study. Spearman correlations and multivariable regressions were used to examine whether resistin levels were associated with SLE, disease-specific and inflammatory markers, insulin resistance, and CAC.Results.In a multivariable linear regression model, a diagnosis of SLE was significantly associated with higher resistin levels independent of age, race, renal function, body mass index (BMI), high-sensitivity CRP (hsCRP), hypertension, diabetes, and steroid use. In SLE, resistin levels correlated positively with Systemic Lupus International Collaborating Clinics Damage Index, glomerular filtration rate (GFR), hsCRP, erythrocyte sedimentation rate, homocysteine, and disease duration (all p < 0.03). Resistin level did not correlate with markers of insulin resistance or body adiposity, including homeostatic model assessment or BMI. Resistin levels were significantly elevated in SLE cases with CAC compared to cases without CAC (16.58 vs 13.10 ng/ml, respectively; p = 0.04). In multivariate logistic regression, the association was not present after adjustment for age, race, and GFR.Conclusion.SLE was independently associated with higher resistin levels. Among subjects with SLE, higher resistin level correlated positively with renal dysfunction, inflammatory markers, and disease damage but not with insulin resistance or BMI. SLE cases with CAC had higher resistin levels than cases without CAC; however, this relationship was dependent on other established risk factors.

Association of Resting Heart Rate With Arterial Stiffness and Low-Grade Inflammation in Women With Systemic Lupus Erythematosus

Angiology ◽  
2017 ◽  
Vol 69 (8) ◽  
pp. 672-676 ◽  
Author(s):  
José Antonio Vargas-Hitos ◽  
Alberto Soriano-Maldonado ◽  
Josefa Martínez-Bordonado ◽  
Isabel Sánchez-Berná ◽  
Daniel Fernández-Bergés ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Arterial Stiffness ◽  
Lupus Erythematosus ◽  
Low Grade ◽  
Model Assessment ◽  
Resting Heart Rate ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Low Grade Inflammation

Resting heart rate (RHR) is associated with arterial stiffness, inflammation, and cardiovascular (CV) and all-cause mortality in the general population and in patients at high CV risk. We assessed the association of RHR with arterial stiffness and low-grade inflammation (LGI) in a cross-sectional study that included 101 women with systemic lupus erythematosus (SLE) without a history of CV disease or arrhythmia or who were under treatment that may cause bradycardia. Pulse wave velocity (PWV; a measure of arterial stiffness), RHR, and markers of LGI (ie, C-reactive protein, fibrinogen, erythrocyte sedimentation rate, insulin, and homeostatic model assessment index) were measured. The patients with the highest RHR (quartile 4; mean RHR = 87.2 bpm) had a PWV 0.61 m/s (95% confidence interval [CI]: 0.08-1.14; P = .024) greater than patients with the lowest RHR (quartile 1; RHR = 63.0 bpm), independent of age, systolic blood pressure, disease activity, smoking, and being physically inactive. Similarly, patients with the highest RHR (quartile 4) showed a significantly less favorable clustered LGI index than patients in quartile 1 ( b = .58; 95% CI: 0.212-0.948; P = .002). Higher RHR is associated with greater arterial stiffness and LGI in women with SLE. Further research to determine the prognostic value of RHR in this population is warranted.

Insulin resistance and serum levels of adipokines in patients with systemic lupus erythematosus: a systematic review and meta-analysis

Lupus ◽  
2020 ◽  
Vol 29 (9) ◽  
pp. 1078-1084
Author(s):  
Che-Yuan Kuo ◽  
Tsung-Yu Tsai ◽  
Yu-Chen Huang
Keyword(s):  
Systematic Review ◽  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Serum Levels ◽  
Serum Adiponectin ◽  
Model Assessment ◽  
Systemic Lupus

Background We aimed to perform a systematic review and meta-analysis of studies assessing the homeostasis model assessment for insulin resistance (HOMA-IR) values, serum adiponectin, leptin and resistin levels in patients with systemic lupus erythematosus (SLE). Method Online databases were searched on 31 March 2019 in order to identify studies comparing HOMA-IR, serum adiponectin, leptin and resistin levels between patients with SLE and controls. A random-effects model was adopted. Results Fifty-six studies involving a total of 4460 patients with SLE were included. Patients with SLE had significantly higher HOMA-IR values (standardized mean difference (SMD)=0.425; 95% confidence interval (CI) 0.156–0.693; I2=93.8%) than the control group. The serum levels of adiponectin (SMD=0.547; 95% CI 0.219–0.874; I2=90.1%), leptin (SMD=0.843; 95% CI 0.454–1.231; I2=94.4%) and resistin (SMD=0.856; 95% CI 0.199–1.513; I2=96.6%) were all higher among patients with SLE than controls. A meta-regression analysis revealed that the serum resistin level was positively correlated with disease activity (coefficient 0.123; 95% CI 0.051–0.195; p<0.001). Conclusion Patients with SLE have higher HOMA-IR values and serum levels of adiponectin, leptin and resistin than individuals without SLE. The serum level of resistin correlates with SLE disease activity.

Higher Prevalence and Degree of Insulin Resistance in Patients with Rheumatoid Arthritis than in Patients with Systemic Lupus Erythematosus

2020 ◽  
pp. jrheum.200435
Author(s):  
Juan C. Quevedo-Abeledo ◽  
Hiurma Sánchez-Pérez ◽  
Beatriz Tejera-Segura ◽  
Laura de Armas-Rillo ◽  
Soledad Ojeda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Beta Cell ◽  
Lupus Erythematosus ◽  
Beta Cell Function ◽  
Cell Function ◽  
Multivariable Analysis ◽  
Model Assessment ◽  
Systemic Lupus

Objective Since insulin resistance (IR) is highly prevalent in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), we aimed to determine whether differences in IR between the two conditions exist. Methods Cross-sectional study that encompassed 413 non-diabetic subjects, 186 SLE and 227 RA. Glucose, insulin and C-peptide serum levels, as well as IR by the homeostatic model assessment (HOMA2) were studied. A multivariable regression analysis was performed to evaluate the differences in IR indexes between patients with SLE and RA, and also to determine if IR risk factors or disease-related characteristics are differentially associated with IR in both populations. Results The insulin:C-peptide molar ratio was upregulated in RA compared to SLE patients (beta coef. 0.009 [95%CI 0.005-0.014], p=0.000) after multivariable analysis. HOMA2 indexes related to insulin sensitivity were found to be lower (HOMA2-S% beta coef. -27 [95%CI -46- -9], p=0.004) and beta cell function showed higher IR indexes (HOMA2-B% beta coef. 38 [95%CI 23-52], p=0.000) in RA than in SLE patients after multivariable analysis. RA patients more often fulfilled the definition of IR than those with SLE (odds ratio 2.15 [95%CI 1.25-3.69], p=0.005). The size effect of IR factors on IR indexes was found to be equal in both diseases. Conclusion IR sensitivity is lower and beta cell function is higher in RA than in SLE patients. The fact that traditional IR factors have an equal effect on IR in both SLE and RA supports the contention that these differences are related to the diseases themselves.

Photoprotective habits in children with systemic lupus erythematosus

Lupus ◽  
2020 ◽  
Vol 29 (8) ◽  
pp. 964-969
Author(s):  
Tipusa Janthongsri ◽  
Wanee Wisuthsarewong ◽  
Rattanavalai Nitiyarom
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
Multiple Organ ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Face To Face ◽  
Organ Systems ◽  
Siriraj Hospital

Background Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can involve multiple organ systems. Exposure to ultraviolet radiation (UVR) can exacerbate pre-existing SLE, and can even induce systemic manifestations. This study aimed to investigate the photoprotective habits of children with SLE and the factors that significantly influence those photoprotective habits. Methods This questionnaire-based cross-sectional study included paediatric SLE patients being treated at the Department of Paediatrics at Siriraj Hospital, Mahidol University, between September 2018 and September 2019. Data were obtained from medical records and a face-to-face interview. Results Ninety-six patients were enrolled, with a female-to-male ratio of 8:1. The mean age of patients at enrollment was 13.7 ± 2.4 years. Of the 96 patients, 70 (72.9%) reported being directly exposed to sunlight for less than two hours per day, but 39% of patients spent time in the sun during the peak hours of UVR. Up to 95% of patients used sunscreen. However, only 64% of patients applied it every day, and only 35% of patients used an adequate amount of sunscreen. Girls were significantly more likely to apply sunscreen every day than boys were ( p = 0.041). SLE patients with a shorter disease duration had significantly greater exposure to sunlight than patients with a disease duration of more than four years ( p = 0.040). Conclusion Sunscreen was the most common photoprotective method. However, most patients used sunscreen inappropriately. A shorter disease duration was significantly associated with more sunlight exposure. Regular evaluation and emphasis of the importance of photoprotection should be encouraged among paediatric SLE.

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