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Rheumatology Advance Access originally published online on March 5, 2009
Rheumatology 2009 48(5):497-501; doi:10.1093/rheumatology/kep030
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Adipokines as novel biomarkers in paediatric systemic lupus erythematosus

Marjon Al1, Lawrence Ng1, Pascal Tyrrell1, Joanne Bargman2, Timothy Bradley3 and Earl Silverman1

1Division of Rheumatology, Department of Pediatrics, SickKids Hospital,2Division of Nephrology, Department of Medicine, University Health Network and 3Division of Cardiology, Department of Pediatrics, SickKids Hospital, University of Toronto, Toronto, Ontario, Canada.

Correspondence to: Earl Silverman, Division of Rheumatology, Department of Pediatrics, Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8. E-mail: earl.silverman{at}sickkids.ca


  Abstract

Objectives. Patients with SLE are at risk for premature atherosclerosis and metabolic syndrome. Cytokines produced by adipocytes, adipokines, are important in glucose/lipid metabolism and the development of atherosclerosis. The objectives of this study were to evaluate leptin, adiponectin and ghrelin concentrations in paediatric SLE (pSLE) and to correlate these concentrations with measures of disease activity, serum lipid concentrations, measures of insulin resistance and serum homocysteine concentrations.

Methods. Two hundred and eight samples from 105 patients with pSLE and 77 samples from 77 healthy paediatric controls were evaluated by ELISA to measure leptin, adiopnectin and ghrelin. Students’ t-test was used for analysis. Concentrations of adipokines were correlated with disease activity, serum lipids, insulin resistance and homocysteine.

Results. Overall 35 SLE patients (34%) had an abnormally elevated leptin level. The only significant correlation of leptin concentrations was with homocysteine concentrations but not disease activity, prednisone dose, lipids or insulin resistance. There was no difference in the mean adiponectin concentrations between the control and patient groups and none of the patient samples were below the normal lower limit while seven were elevated. There was a significant correlation of adiponectin concentrations with prednisone dose, lipid concentrations and insulin resistance but not with disease activity or homocysteine. Elevated ghrelin concentrations were found in 20% of the pSLE patients. The only correlation of ghrelin concentrations was with homocysteine.

Conclusions. Adipokines are novel biomarkers in pSLE. They may represent cardiovascular risk and are not just surrogate markers for disease activity, therapy or serum lipids. Their correlation with atherosclerosis needs to be explored.

KEY WORDS: Paediatric SLE, Atherosclerosis, Leptin, Ghrelin, Adiponectin, Paediatric rheumatology, Biomarkers

Submitted 12 August 2008; revised version accepted 22 January 2009.
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