Serum level of adiponectin is a surrogate independent biomarker of radiographic disease progression in early rheumatoid arthritis: results from the ESPOIR cohort.

International audienceINTRODUCTION: Adipokines as adiponectin, leptin and visfatin/nicotinamide phosphoribosyltransferase (NAMPT) have recently emerged as pro-inflammatory mediators involved in the pathophysiology of rheumatoid arthritis (RA). We aimed to determine whether serum adipokine levels independently predicted early radiographic disease progression in early RA. METHODS: A total of 791 patients were included from the prospective Etude et Suivi des POlyarthrites Indifferenciees Recentes (ESPOIR) cohort who met the American College of Rheumatology-European League Against Rheumatism criteria for RA (n = 632) or had undifferentiated arthritis (UA) (n = 159). ELISA was used to assess baseline serum levels of adiponectin, leptin and visfatin/NAMPT. In the RA group, we tested the association of serum adipokine levels and 1) baseline radiographic damage and 2) radiographic disease progression defined as a change > 0 or >= 5 in total Sharp-van der Heijde Score ([increment]SHS) between inclusion and 1 year ([increment]SHS >=1 or rapid radiographic progression: [increment]SHS >= 5) adjusting for confounders (age, sex, body-mass-index, insulin resistance, C-reactive protein level, Disease Activity Score in 28 joints, Health Assessment Questionnaire score, auto-antibody status, steroid use and radiographic evidence of RA damage at inclusion). RESULTS: Adiponectin level was independently associated with baseline total SHS (adjusted beta = 0.12; p = 0.006). It was also associated with [increment]SHS >=1 (adjusted odds ratio [aOR] = 1.84 [1.25-2.72]) involving erosive as well as narrowing disease progression (aOR = 1.73 [1.17-2.55] and 1.93 [1.04-3.57], respectively). Serum adiponectin level predicted [increment]SHS >= 5 (aOR = 2.0 [1.14-3.52]). Serum leptin level was independently associated only with [increment]SHS > 0 (aOR = 1.59 [1.05-2.42]). Conversely, serum visfatin/NAMPT level and radiographic disease progression were unrelated. Considering the receiver-operated characteristic curves, the best adiponectin cut-off were 4.14 mug/mL for [increment]SHS >= 1 and 6.04 mug/mL for [increment]SHS >= 5 with a good specificity (58% and 75% for [increment]SHS >= 1 and [increment]SHS >= 5, respectively) and high negative predictive values (75% and 92% for [increment]SHS >= 1 or [increment]SHS >= 5, respectively). CONCLUSION: Serum adiponectin level is a simple useful biomarker associated with early radiographic disease progression in early RA independent of RA-confounding factors and metabolic status