Adipokines, inflammation, insulin resistance, and carotid atherosclerosis in patients with rheumatoid arthritisReportar como inadecuado

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Arthritis Research and Therapy

, 15:R194

First Online: 19 November 2013Received: 28 May 2013Accepted: 06 November 2013


IntroductionCardiovascular CV morbidity and mortality are increased in patients with rheumatoid arthritis RA. Inflammation is thought to be an important factor in accelerated atherosclerosis in RA, whereas insulin resistance is a known risk factor for atherosclerosis in RA. We hypothesised that adipokines could be a link between inflammation, insulin resistance, and atherosclerosis in RA.

MethodsThe common carotid artery CCA intima-media thickness IMT, CCA resistive index RI, and carotid plaques were measured by ultrasonography in 192 patients with RA. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance HOMA-IR. Serum adiponectin, leptin, resistin, tumor necrosis factor-α, and interleukin IL-6 concentrations were determined.

ResultsThe CCA RI was associated with CCA IMT and the estimated total plaque volume after adjustment for conventional CV risk factors. Among adipokines, resistin and IL-6 were correlated with inflammatory parameters. Leptin and leptin:adiponectin L:A ratio were correlated with metabolic risk factors, including HOMA-IR. And L:A ratio was related to the CCA RI after adjustment for conventional and nonconventional CV risk factors, including HOMA-IR, erythrocyte sedimentation rate and C-reactive protein.

ConclusionL:A ratio was associated with HOMA-IR and carotid RI. L:A ratio might be an independent factor for predicting cardiovascular risk in patients with RA.

AbbreviationsBMIBody mass index

CCACommon carotid artery

CRPC-reactive protein


DAS28Disease Activity Score in 28 joints

ESRErythrocyte sedimentation rate

HDLHigh-density lipoprotein

HOMA-IRHomeostatic model assessment for insulin resistance


IMTIntima-media thickness

LA ratio: Leptin:adiponectin ratio

RARheumatoid arthritis

RIResistive index


Electronic supplementary materialThe online version of this article doi:10.1186-ar4384 contains supplementary material, which is available to authorized users.

Yoon Kang, Hee-Jin Park contributed equally to this work.

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Autor: Yoon Kang - Hee-Jin Park - Mi-I Kang - Hyang-Sun Lee - Sang-Won Lee - Soo-Kon Lee - Yong-Beom Park


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