ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1821

Leptin, Adiponectin, and Resistin As Serum Markers of Fatigue in Systemic Lupus Erythematosus: A Pilot Study

Mary Mahieu1, Grace Ahn2, Joan S. Chmiel3, Dorothy D. Dunlop4, Irene Helenowski3, Pamela Semanik5, Jing Song4, Rowland W. Chang3 and Rosalind Ramsey-Goldman6, 1Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, 2Rheumatology, Falls Medical Specialists, Baltimore, MD, 3Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 4Institute for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, 5Nursing, Rush University College of Nursing, Chicago, IL, 6Northwestern University Feinberg School of Medicine, Chicago, IL

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Monday, November 9, 2015

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Fatigue, a common symptom in systemic lupus erythematosus (SLE) patients, is ameliorated by physical activity. Adiposity and adipokines may be associated with patient-reported fatigue. We describe associations between adipokines (leptin, adiponectin, and resistin) and fatigue, physical activity, and SLE disease activity.

Methods: We examined adipokines, self-reported fatigue, and objective physical activity in 129 patients meeting ACR revised criteria for definite SLE from the Activity in Lupus to Energize and Renew (ALTER) study. Body mass index (BMI), disease activity (Safety of Estrogens in Systemic Lupus Erythematosus National Assessment – Systemic Lupus Erythematosus Disease Activity Index [SELENA-SLEDAI]), and disease damage (Systemic Lupus International Collaborating Clinics Damage Index [SDI]) were measured. Fatigue was assessed by the Fatigue Severity Scale (FSS). A triaxial accelerometer was worn for 7 days, and physical activity was estimated by total accelerometer vector magnitude (VM) counts. Six patients with <4 valid days of accelerometer wear were excluded from physical activity analyses. Leptin, adiponectin, and resistin were measured in stored serum with a Luminex bead-based assay. Adipokine data were logarithmically transformed for inclusion in linear regression models describing relationships between FSS and adipokines. Spearman correlation coefficients assessed associations between adipokines, physical activity, and SELENA-SLEDAI.

Results: Participants were female (94%), Caucasian (53%), and mean age 45.5 years (SD 10.9). BMI was 28.1 kg/m2 (8.2). SELENA-SLEDAI was 2.4 (2.8) and SDI was 1.7 (2.2). FSS score was 4.4 (1.6), consistent with clinically relevant fatigue. Mean adipokine levels were: leptin 44.2 ng/ml (47.6), adiponectin 13.5 μg/ml (10.8) and resistin 1.9 ng/ml (1.5). No significant associations were found between adipokines and FSS in any of the regression models (Table 1). BMI ≥ 30 kg/m2 (obesity) was associated with FSS in adjusted models (p <0.05, data not shown). Weak correlations between leptin, adiponectin, and physical activity, and between adiponectin and SELENA-SLEDAI score, were not significant after adjusting for BMI (Table 2).

Conclusion: No relationships were found between adipokines and fatigue in SLE patients. This study demonstrates that adipokines are correlated with physical activity (leptin and adiponectin) and SLE disease activity (adiponectin), but most of these associations can be explained by BMI.

 

Table 1. Linear regression model results for FSS (dependent variable) and each adipokine measure (predictor variable, natural log scale)

 

Adjustment Variables

Regression coefficient

Leptin

Adiponectin

Resistin

Model 1

Unadjusted

β

0.25

-0.11

0.36

95% CI

-0.05, 0.54

-0.53, 0.32

-0.08, 0.81

Model 2

BMI, age, sex, race/ethnicity

β

-0.12

0.08

0.32

95% CI

-0.59, 0.35

-0.39, 0.55

-0.12, 0.76

Model 3

Model 2 plus

SELENA-SLEDAI

β

-0.17

0.02

0.26

95% CI

-0.65, 0.30

-0.46, 0.50

-0.19, 0.72

Model 4

Model 2 plus total accelerometer VM counts and wear time (n=123)

β

-0.14

0.26

0.24

95% CI

-0.61, 0.32

-0.21, 0.72

-0.21, 0.70

CI = confidence interval

 

Table 2. Spearman correlations for adipokines, physical activity, and SLE disease activity

 

Adjustment Variables

Correlation coefficient

Leptin

Adiponectin

Resistin

Total accelerometer VM counts (n=123)

Accelerometer wear time

r

-0.25

0.20

-0.07

95% CI

-0.41, -0.08

0.02, 0.36

-0.25, 0.10

Accelerometer wear time plus BMI

r

-0.06

0.11

-0.04

95% CI

-0.24, 0.12

-0.08, 0.28

-0.22, 0.14

SELENA-SLEDAI (n=129)

Unadjusted

r

0.02

0.18

0.08

95% CI

-0.15, 0.19

0.01, 0.34

-0.09, 0.25

BMI

r

0.16

0.15

0.09

95% CI

-0.02, 0.32

-0.02, 0.32

-0.08, 0.26

Bolded r-values (95% CI) indicate statistical significance.

Disclosure: M. Mahieu, None; G. Ahn, None; J. S. Chmiel, None; D. D. Dunlop, None; I. Helenowski, None; P. Semanik, None; J. Song, None; R. W. Chang, None; R. Ramsey-Goldman, None.

To cite this abstract in AMA style:

Mahieu M, Ahn G, Chmiel JS, Dunlop DD, Helenowski I, Semanik P, Song J, Chang RW, Ramsey-Goldman R. Leptin, Adiponectin, and Resistin As Serum Markers of Fatigue in Systemic Lupus Erythematosus: A Pilot Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/leptin-adiponectin-and-resistin-as-serum-markers-of-fatigue-in-systemic-lupus-erythematosus-a-pilot-study/. Accessed .

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