Session Type: Abstract Submissions (ACR)
Background/Purpose: To identify the association between serum leptin and adiponectin levels and proteinuria secondary to lupus nephritis in women with systemic lupus erythematosus (SLE).
Methods: One-hundred and four women with SLE were included in the study. All of them were assessed in order to identify the presence of lupus nephritis; proteinuria levels in 24 hours were identified, patients were classified in two groups: SLE with proteinuria ≥0.5 g in 24 h secondary to lupus nephritis (SLE + proteinuria n=30) and SLE without nephritis (n=74). Patients with proteinuria secondary to causes different to nephritis were excluded. Other assessments included modified-SLEDAI (m-SLEDAI) for disease activity, SLICC/ACR and Body Mass Index (BMI). Serum levels of leptin, and adiponectin were measured by ELISA. Leptin was adjusted by BMI. Statistical analysis included a comparison of means between groups using Student t-test for independent samples, Pearson correlation test to identify strength of association between serum leptin and adiponectin levels with proteinuria and other quantitative variables. A multiple regression analysis was used to adjust for confounders.
Results: In the comparison between groups there were no statistically significant differences in age, weight or BMI between SLE + proteinuria versus SLE without nephritis. The group with SLE + proteinuria had higher serum adiponectin levels compared with SLE without nephritis (20.11±10.58 μg/mL vs. 15.36±7.83 μg/mL respectively; p=0.032). Serum leptin levels were not statistically different between the group with SLE + proteinuria compared with SLE without nephritis (28.68±25.79 ng/mL vs. 23.43±29.15 ng/mL respectively; p=0.39). Serum leptin levels had a positive correlation with weigh (r=0.306, p=0.002), BMI (r=0.327, p=0.001), serum creatinine in mg/dL (r=0.283, p=0.004), chloroquine (r=0.262, p=0.009) and prednisone doses (mg/day) (r=0.207, p=0.035) but did not correlated with proteinuria (r=-0.014, p=0.893) neither with m-SLEDAI (r=0.092, p=0.357) and SLICC/ACR (r=0.083, p=0.408). Serum adiponectin levels correlated with serum creatinine (r=0.255, p=0.010) and proteinuria (r=0.305, p=0.002), m-SLEDAI (r=0.299, p=0.002), chloroquine (r=0.203, p=0.046) and prednisone doses (r=0.343, p=<0.001), but there was no correlation between adiponectin and SLICC/ACR (r=0.085, p=0.394). A negative correlation was observed between adiponectin and weigh (r=-0.204, p=0.038), BMI (r=-0.203, p=0.039) and fast glucose serum levels (r=-0.347, p=<0.001). In the multivariate analysis, after adjusting by age, disease duration, BMI and leptin, serum adiponectin levels remained associated with severity of proteinuria (p=0.005).
Conclusion: Serum adiponectin levels were higher in women with SLE + proteinuria compared to SLE without nephritis. Longitudinal studies should be performed in order to identify if patients with proteinuria and high serum adiponectin levels have differences in the development of response to therapies directed against of nephritis.
Founding: This project was supported by Instituto Mexicano del Seguro Social with the no. FIS/IMSS/PROT/G11/937.
N. S. Fajardo-Robledo,
A. J. Ruiz-Padilla,
T. M. Rodriguez-Hernandez,
M. Vazquez del Mercado,
J. I. Gamez-Nava,
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ACR Meeting Abstracts - http://acrabstracts.org/abstract/association-between-serum-leptin-and-adiponectin-levels-with-the-severity-of-proteinuria-in-lupus-nephritis/