Background/Purpose: Patients with rheumatoid arthritis (RA) tend to have impaired distribution of adipose tissue and may have the risks of metabolic complications (1,2). The aim of this study was to determine the serum adiponectin levels and body composition in a group of patients with RA.

Methods: Fifty-five RA patients with a mean age of 53.5±9.7 years were recruited to this cross-sectional study. The demographic and clinical variables of the patients (age, sex, BMI, duration of disease) were determined. Disease activity parameters (DAS28-ESR, functional status assessed by HAQ and quality of life (QoL) assessed by RA-QoL questionnaires) were recorded. Serum adiponectin levels and body composition parameters (fat mass (FM) and fat-free mass (FFM)) were determined by ELISA and multi-frequency bioelectrical impedenace analysis respectively. Anthropometric measurements (weight, height, circumferences of waist (WC), mid-upper arm (MUAC), calf (CC) and neck (NC) and muscle strength assessments (hand-grip) were performed by a trained dietitian. The relationship between disease activity parameters, adiponectin levels and body composition variables were analyzed by Pearson and Spearman tests as needed.

Results: Forty-four female, 11 male RA patients with a mean disease duration of 127.0± 120.6 months were included to the study. Based on BMI, 23.6% of patients were overweight and 60% were obese. Obesity prevelance and mean fat mass (%) was significantly higher among female patients (p=0.000, for both). According to DAS28-ESR parameters 38.2% of patients were in remission state, 18.2% had low, 40% had moderate, 3.6% had severe disease activity. Disease activity parameters did not differ among female and male patients, while functional status determined by HAQ and quality of life assessed by RA-QoL scores of female patients were significantly higher than male patients (1.2±1.2 and 0.6±0.6, p<0.05; 12.7±8.3 and 6.0±4.5, p<0.05, respectively), indicating more disability in women. The mean serum adiponectin value was 16.08±6.95 µg/mL and did not differ significantly between sexes.  Adiponectin was positively corelated with body fat (%) (r=0.427 p=0.001) and negatively corelated with fat-free mass (%) (r=-0.316, p;=0.021). Correlation between serum adiponectin and body fat was siginificant among female patients (r=0.409, p=0.006). No statistically significant correlations were found between serum adiponectin levels and anthropometric measurements. Body fat (%) was positively (r=0.609, p=0.047), fat-free mass (%) was negatively (r=-0.609, p=0.047) correlated with disease activity determined by DAS28-ESR.

Conclusion:  Our data indicate that body composition is altered in RA patients and related with adinopectin and disease activity, which may increase the risk of cardiovascular disease, and emphasize an unmet need of dietitian consultation in the management of RA. References:

1. Dessein PH, Tsang L, Solomon A, et al. Adiponectin and atherosclerosis in rheumatoid arthritis. Mediators Inflamm. 2014;2014:358949. 
2. Kang Y, Park HJ, Kang M. Adipokines inflammation, insülin resistance, and carotid atherosclerosis in patients with rheumatoid arthritis. Arthritis Res Ther 2013;15:r194.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-adiponectin-and-body-composition-in-a-group-of-patients-with-rheumatoid-arthritis-relationship-between-disease-parameters/