Adipocytokines: Adiponectin, Resistin and Visfatin in Serum and Synovial Fluid of Rheumatoid Arthritis Patients and Their Relation to Disease Activity

Background: Adipocytokines; adiponectin, visfatin and resistin are mainly adipocyte-derived cytokines regulating metabolism and as such are key regulators of insulin resistance. Recent data provided evidence on the implication of these adipocytokines in the inflammation, immune response and tissue destruction and revealed several links between them and arthritis. These data suggest a possible role of adipocytokines in the modulation of the inflammatory environment in rheumatoid arthritis (RA). Aim of the Study: The purpose of this study was to assess the level of adiponectin, visfatin and resistin in serum and synovial fluid from patients with rheumatoid arthritis and their relation to the disease activity. Subjects and Methods: Seventy female patients with RA and 30 age and sex matched healthy controls were enrolled. The clinical activity of RA patients was assessed according to the 28 joint count Disease Activity Score and patients were classified into two groups; 39 patients with active disease (group A) and 31 patients in remission (group B). Synovial fluid was obtained by arthrocentesis of the affected knee joints from 39 patients with active disease. Serum adiponectin, visfatin and resistin concentrations were measured in RA patients, controls and their synovial concentrations in active group by using specific enzyme-linked immunosorbent assays. Results: Serum levels of adiponectin and visfatin were significantly higher in all studied RA patients and patients with active disease compared with control group and patients in remission. No significant difference was observed in resistin level between patients and controls. Serum adeponectin, visfatin and resistin levels were significantly higher than their synovial fluid concentrations in patients with active RA. Conclusion: Our data support the hypothesis that adiponectin and visfatin are involved in the inflammatory process of rheumatoid arthritis.