Rheumatology Advance Access originally published online on September 2, 2008
Rheumatology 2008 47(11):1736; doi:10.1093/rheumatology/ken340
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Comment on: Serum leptin and ghrelin correlate with disease activity in ANCA-associated vasculitis
1Department of Rheumatology, Altnagelvin Hospital, Londonderry, UK
Correspondence to: D. J. Armstrong, Department of Rheumatology, Altnagelvin Hospital, Glenshane Road, Londonderry BT47 6SB, UK. E-mail: oswald17727{at}hotmail.com
SIR, The results of the study by Kümpers et al. [1] on leptin and ghrelin levels in systemic vasculitis are unexpected according to current understanding of the action of these hormones in rheumatic disease, but all the more interesting for that reason. However, the authors state in their discussion that serum leptin levels are decreased in RA, in contrast to the findings they present in systemic vasculitis. In fact, the situation is far from clear, and the study by Popa et al. [2], which they quote, did not in fact find a significant difference between RA and control subjects, but instead did detect a negative correlation between markers of inflammation and leptin within the RA group.
Of the nine studies (seven in English) that have examined serum leptin levels in RA patients as compared with healthy controls published in the last 10 yrs, one found serum leptin levels to be lower in RA, six (including Popa et al.'s study) found no significant difference and two found higher levels. Even the correlation with disease activity is not established; at least eight studies have found no relationship between leptin levels and inflammatory markers in RA, three recently published papers have actually suggested a positive relationship [3–5] and anti-TNF-
therapy in RA appears to leave the levels unchanged [6].
Leptin is a fascinating peptide, which provides a tantalizing link between adipose tissue and inflammation. The lack of clarity even in observational studies, however, shows just how far we have to go to understand its role in rheumatic disease.
Disclosure statement: The author has declared no conflicts of interest.
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- Kümpers P, Horn R, Brabant G, et al. Serum leptin and ghrelin correlate with disease activity in ANCA-associated vasculitis. Rheumatology (2008) 47:484–7.
[Abstract/Free Full Text] - Popa C, Netea MG, Radstake TR, van Riel PL, Barrera P, van der Meer JW. Markers of inflammation are negatively correlated with serum leptin in rheumatoid arthritis. Ann Rheum Dis (2005) 64:1195–8.
[Abstract/Free Full Text] - Targo
ska-Stepniak B, Majdan M, Dryglewska M. Leptin serum levels in rheumatoid arthritis patients: relation to disease duration and activity. Rheumatol Int (2008) 28:585–91.[CrossRef][Web of Science][Medline] - Ljung L, Olsson T, Engstrand S, Wållberg-Jonsson S, Söderberg S, Rantapää-Dahlqvist S. Interleukin-1 receptor antagonist is associated with both lipid metabolism and inflammation in rheumatoid arthritis. Clin Exp Rheumatol (2007) 25:617–20.[Web of Science][Medline]
- Lee SW, Park MC, Park YB, Lee SK. Measurement of the serum leptin level could assist disease activity monitoring in rheumatoid arthritis. Rheumatol Int (2007) 27:537–40.[CrossRef][Web of Science][Medline]
- Härle P, Sarzi-Puttini P, Cutolo M, Straub RH. No change of serum levels of leptin and adiponectin during anti-tumour necrosis factor antibody treatment with adalimumab in patients with rheumatoid arthritis. Ann Rheum Dis (2006) 65:970–1.
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