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Federico LE, Johnson TM, England BR, Wysham KD, George MD, Sauer B, Hamilton BC, Hunter CD, Duryee MJ, Thiele GM, Mikuls TR, Baker JF. Circulating Adipokines and Associations With Incident Cardiovascular Disease in Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2023; 75:768-777. [PMID: 35313088 PMCID: PMC10588673 DOI: 10.1002/acr.24885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/09/2022] [Accepted: 03/17/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess whether circulating levels of adiponectin, leptin, and fibroblast growth factor 21 (FGF-21) are associated with incident cardiovascular disease (CVD) in rheumatoid arthritis (RA). METHODS Adipokines were measured using banked enrollment serum from patients with RA and dichotomized above/below the median value. Incident CVD events (coronary artery disease [CAD], stroke, heart failure [HF] hospitalization, venous thromboembolism, CVD-related deaths) were identified using administrative data and the National Death Index. Covariates were derived from medical record, biorepository, and registry databases. Multivariable Cox models were generated to quantify associations between adipokine concentrations and CVD incidence. Five-year incidence rates were predicted. RESULTS Among 2,598 participants, 639 (25%) had at least 1 CVD event over 19,585 patient-years of follow-up. High adiponectin levels were independently associated with HF hospitalization (hazard ratio [HR] 1.39 [95% confidence interval (95% CI) 1.07-1.79], P = 0.01) and CVD-related death (HR 1.49 [95% CI 1.16-1.92], P = 0.002) but not with other CVD events. High leptin was independently associated with CVD-related death (HR 1.44 [95% CI 1.05-1.97], P = 0.02). High FGF-21 levels were independently associated with lower rates of CAD (HR 0.75 [95% CI 0.58-0.97], P = 0.03). In subgroup analyses, associations between high adiponectin and leptin levels with CVD-related death were driven by strong associations in nonobese patients. CONCLUSION Adipokines are associated with HF hospitalization and CVD-related death in patients with RA, with stronger associations in nonobese participants. These findings suggest that adipokines effectively predict clinically important outcomes in RA perhaps through an association with body composition and metabolic health. Further study is needed to determine whether adipokine measures might augment existing tools to identify RA patients at increased risk of CVD.
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Affiliation(s)
| | - Tate M. Johnson
- Tate M. Johnson, MD, Bryant R. England, MD, PhD, Geoffrey M. Thiele, PhD, Ted R. Mikuls, MD, MSPH: Veterans Affairs Nebraska–Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, Nebraska
| | - Bryant R. England
- Tate M. Johnson, MD, Bryant R. England, MD, PhD, Geoffrey M. Thiele, PhD, Ted R. Mikuls, MD, MSPH: Veterans Affairs Nebraska–Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, Nebraska
| | - Katherine D. Wysham
- Katherine D. Wysham, MD: Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle
| | - Michael D. George
- Michael D. George, MD, MSCE: University of Pennsylvania, Philadelphia
| | - Brian Sauer
- Brian Sauer, PhD: University of Utah Medical Center and Veterans Affairs Salt Lake City Health Care System, Salt Lake City
| | - Bartlett C. Hamilton
- Bartlett C. Hamilton, MPH, Carlos D. Hunter, BS, Michael J. Duryee, MS: University of Nebraska Medical Center, Omaha
| | - Carlos D. Hunter
- Bartlett C. Hamilton, MPH, Carlos D. Hunter, BS, Michael J. Duryee, MS: University of Nebraska Medical Center, Omaha
| | - Michael J. Duryee
- Bartlett C. Hamilton, MPH, Carlos D. Hunter, BS, Michael J. Duryee, MS: University of Nebraska Medical Center, Omaha
| | - Geoffrey M. Thiele
- Tate M. Johnson, MD, Bryant R. England, MD, PhD, Geoffrey M. Thiele, PhD, Ted R. Mikuls, MD, MSPH: Veterans Affairs Nebraska–Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, Nebraska
| | - Ted R. Mikuls
- Tate M. Johnson, MD, Bryant R. England, MD, PhD, Geoffrey M. Thiele, PhD, Ted R. Mikuls, MD, MSPH: Veterans Affairs Nebraska–Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, Nebraska
| | - Joshua F. Baker
- Joshua F. Baker, MD, MSCE: University of Pennsylvania and Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia
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Challener GJ, Myasoedova E, Crowson CS, Giblon RE, Atkinson EJ, Davis JM. Body mass index trend and variability in rheumatoid arthritis. Clin Rheumatol 2022; 41:349-355. [PMID: 34510294 PMCID: PMC10440724 DOI: 10.1007/s10067-021-05919-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/16/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To characterize and compare trends in body mass index (BMI) and variability in BMI between subjects with rheumatoid arthritis (RA) and matched non-RA subjects and to determine predictors of BMI trends and variability within RA subjects. METHODS This retrospective population-based cohort study included 1114 Olmsted County, Minnesota residents, 558 with incident RA (age ≥ 18 years, 1987 ACR criteria met in 1995-2009) and 556 non-RA subjects from the same underlying population with similar age, sex, and index calendar year. All subjects were followed until death, migration, or 12/31/2018. Generalized linear models with smoothing splines and random effects to account for multiple measurements per subject were used to examine trends in BMI measurements over time. RESULTS Mean BMI of patients with incident RA (28.8 kg/m2) was not significantly different from that of non-RA subjects (28.9 kg/m2). There was no significant difference in BMI trends over time between RA and non-RA cohorts, or between seropositive for rheumatoid factor (RF) and/or citrullinated antibody (CCP-antibody) and seronegative RA patients, or between male and female subjects. RA subjects were noted to have significantly higher BMI variability following diagnosis compared to non-RA subjects [difference in standard deviation between RA and non-RA subjects prior to index (p = 0.12), 0-5 years after index (p = 0.044), and 5-15 years after index (p = 0.013)]. CONCLUSION The BMI trajectory of the RA population is not significantly different compared to that of the non-RA population, but patients with RA demonstrate higher variability in BMI following diagnosis compared to the non-RA population. Key Points • This study uniquely characterizes longitudinal trajectory in BMI measures and their variability in the RA population versus the non-RA population • This study suggests that RA patients have greater BMI variability compared to the non-RA population, which is highly relevant as BMI variability is increasingly understood as a cardiovascular risk factor.
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Affiliation(s)
- Gregory J Challener
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
| | - Elena Myasoedova
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Cynthia S Crowson
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Rachel E Giblon
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - John M Davis
- Division of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
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