Background/Purpose:

Visfatin may represent a novel biomarker of disease severity. Serum visfatin levels are elevated in patients with early rheumatoid arthritis (ERA) and axial spondyloarthritis (AxSpA)^1,2. Serum visfatin levels may be associated with the degree of inflammation, clinical disease activity and radiographic joint damage.

The aim of this study was to analyze serum levels of visfatin in patients with ERA and AxSpA compared to healthy controls (HC) and to investigate their relationship with disease activity and spinal involvement.

Methods:

The study included 23 patients with non-radiographic AxSpA (nr-AxSpA) according to the ASAS criteria with active sacroiliitis confirmed by MRI, 44 patients with radiographic AxSpA (with and without spinal involvement), 40 patients with ERA and age- and sex-matched healthy control (HC) for ERA (n=30) and AxSpA (n=43). Serum visfatin levels were determined by ELISA. Disease activity was assessed by the Disease Activity Score for 28 joints (DAS28) in ERA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in AxSpA. For analysis of differences between groups Mann-Whitney U and for correlations of parameters Spearman’s rank order tests were used.

Results:

Visfatin serum levels were significantly elevated in ERA patients compared to HC (1.92±1.17 vs. 1.36±0.93 ng/ml; p=0.034) and correlated positively with DAS28 (r=0.383, p=0.015) and CRP levels (r=0.456, p=0.003). In all patients with AxSpA, visfatin levels were significantly higher compared to HC (2.79±2.05 vs. 1.22±0.86 ng/ml; p<0.0001) and on the borderline of significance also compared to ERA patients (p=0.051). Furthermore, visfatin levels were significantly higher in patients with radiographic AxSpA compared to nr-AxSpA (3.23±2.24 vs. 1.94±1.28 ng/ml; p=0.013) and there was a borderline difference between radiographic AxSpA with and without spinal involvement (3.79±2.45 vs 2.55±1.79 ng/ml; p=0.067). Serum visfatin levels were not associated with CRP and BASDAI in AxSpA patients.

Conclusion:

Visfatin levels are elevated in both ERA as well as AxSpA patients compared to healthy controls. Although visfatin levels correlate with measures of inflammation in ERA patients, its levels rather reflect radiographic spinal involvement in AxSpA patients in this cross-sectional study. Therefore, we suggest that visfatin possibly plays a distinct role in the pathogenesis of both diseases.

Acknowledgement: This study was supported by Internal Grant Agency of Ministry of Health of the Czech Republic NT/13696-4 and Research Project No. 00023728.

References:

1. Syrbe U, Callhoff J, Conrad K, Poddubnyy D, Haibel H, Junker S, Frommer KW, Müller-Ladner U, Neumann E, Sieper J. Serum adipokine levels in patients with ankylosing spondylitis and their relationship to clinical parameters and radiographic spinal progression. Arthritis Rheumatol. 2015 Mar;67 (3):678-85.

2. Sglunda O, Mann H, Hulejová H, Kuklová M, Pecha O, Pleštilová L, Filková M, Pavelka K, Vencovský J, Senolt L. Decreased circulating visfatin is associated with improved disease activity in early rheumatoid arthritis: data from the PERAC cohort. PLoS One. 2014 Jul 28;9(7):e103495

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-visfatin-levels-in-patients-with-axial-spondyloarthitis-and-early-rheumatoid-arthritis-relation-to-inflammation-and-bone-changes/