Serum Adipokines in Juvenile Dermatomyositis Are Associated with Disease Activities and Cardiac Function

Birgit Nomeland Witczak¹, Kristin Godang², Thomas Schwartz³, Nicoleta Cristina Olarescu⁴, Berit Flatø^5,6, Jens Bollerslev^5,7, Ivar Sjaastad^5,8,9 and Helga Sanner^5,6, ¹Oslo University Hospital, Institute for Experimental Medical Research, Oslo University Hospital, Oslo, Norway, Oslo, Norway, ²Department of Specialised Endocrinology, Oslo University Hospital, Section of Specialised Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, Oslo, Norway, ³Department of Infectious Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway, Oslo, Norway, ⁴Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway., Section of Specialised Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, Oslo, Norway, ⁵Institute for Clinical Medicine, University of Oslo, Oslo, Norway, Oslo, Norway, ⁶Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, Oslo, Norway, ⁷Section of Specialised Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, Oslo, Norway, ⁸Department of Cardiology, Oslo University Hospital, Oslo, Norway, Oslo, Norway, ⁹Institute for Experimental Medical Research, Oslo University Hospital, Oslo, Norway, Oslo, Norway

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Adipokines, adipose tissue, cardiovascular disease and juvenile dermatomyositis

Session Information

Date: Monday, November 14, 2016

Session Title: Pediatric Rheumatology – Clinical and Therapeutic Aspects - Poster II: Myositis, Systemic Lupus Erythematosus, Sjögren's Syndrome

Session Type: ACR Poster Session B

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

Background/Purpose: We have earlier demonstrated redistribution of adipose tissue in JDM patients. There is an increase in visceral adipose tissue (VAT), a highly active metabolic organ producing adipokines which are involved in many inflammatory responses and cardiovascular complications. We aimed to investigate serum adipokine levels in JDM patients and controls, and explore the associations with disease activity and damage, VAT and cardiac function.

Methods: Fifty-nine patients with JDM and 59 age- and sex matched controls were included in a cross sectional study median 16.8years after disease onset. Body composition was analyzed by total body dual-energy X-ray absorptiometry (DXA). VAT (g) was quantified (DXA) only in individuals above 18 years. Serum adipokines, including pro-inflammatory (leptin and visfatin) and anti-inflammatory (adiponectin and apelin-12) analyzed by ELISA, were measured in serum drawn at follow-up. Long axis strain (LAS) and early diastolic tissue velocity (E’) assessed by echocardiography were used as markers for systolic and diastolic cardiac function, respectively. Inactive disease was measured by the PRINTO criteria, disease activity by DAS and disease damage by myositis damage index (MDI).

Results: Leptin levels were higher in patients compared with controls (11.0ng/ml (IQR 4.4-25.2) vs 5.8ng/ml (IQR 3,0-14.7), p=0.010). Adiponectin was lower, but not significant in patients vs. controls (IQR 4.3microgr/ml (IQR 2.7-6.1) vs 5.5microgr/ml (IQR 3.7-6.9), p 0.091). Apelin-12 (0.8 ng/ml (IQR 0.7-1.3) vs 0.7 (IQR 0.6-0.9), p=0.005) and visfatin levels (5.7ng/ml (IQR 4.1-8.1) vs 4.2 (IQR 4.0-6.0), p=0.032) were higher in patients with active than inactive disease. Disease duration, lipodystrophy and calcinosis at follow-up correlated negatively with adiponectin (rsp-0.464, p=0.000; rsp -0.447, p=0.000 and rsp-0.358, p=0.005). Leptin correlated with DAS muscle at follow-up (rsp 0.284, p=0.029). MDI total at follow-up correlated negatively with adiponectin (rsp -0.315, p=0.015). VAT correlated negatively with adiponectin in all patients, with active and inactive disease and also with controls (rsp -0.578, p=0.000; rsp -0.647, p=0.004; rsp -0.492, p=0.028 and rsp -0.445, p=0.007 respectively). LAS and E’ correlated positively with both adiponectin (rsp 0.534, p=0.008 and rsp 0.435, p=0.001) and apelin-12 (rsp 0.347, p=0.007 and rsp 0.279, p=0.034). Leptin correlated with diastolic blood pressure (BP), whereas adiponectin correlated negatively with systolic and diastolic BP, numbers not given.

Conclusion: The pro-inflammatory adipokines leptin and visfatin are elevated in JDM patients and in the subgroup with active disease, respectively. Leptin is associated with higher DAS and elevated blood pressure. Lower levels of anti-inflammatory adipokines (adiponectin and apelin-12) were associated with higher VAT, higher disease activity, higher BP and impaired cardiac function. Our finding suggests that increased VAT and imbalanced adipokine secretion is involved in disease activity and cardiovascular abnormalities in JDM.

Disclosure: B. N. Witczak, None; K. Godang, None; T. Schwartz, None; N. C. Olarescu, None; B. Flatø, None; J. Bollerslev, None; I. Sjaastad, None; H. Sanner, None.

To cite this abstract in AMA style:

Witczak BN, Godang K, Schwartz T, Olarescu NC, Flatø B, Bollerslev J, Sjaastad I, Sanner H. Serum Adipokines in Juvenile Dermatomyositis Are Associated with Disease Activities and Cardiac Function [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/serum-adipokines-in-juvenile-dermatomyositis-are-associated-with-disease-activities-and-cardiac-function/. Accessed December 2, 2020.

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