ABSTRACT
Background: Leptin is a cytokine-like peptide produced mostly by adipose tissue and regulating food intake, basal metabolism and the B- oxidation of fatty acids. It has recently been recognized as a modulator of inflammatory and immune responses, with a possible significant role in the pathogenesis of several autoimmune diseases
Objective: to evaluate the serum leptin levels in patients with systemic Lupus erythematosus [SLE] and rheumatoid arthritis [RA], and its relation to disease activity and systemic complications of each disease
Subjects and Methods: Leptin was measured in the serum of 20 patients with SLE and 20 patients with RA and in 10 healthy control subjects of similar body mass index [BMI]. Each group of SLE and RA patients were subdivided into two subgroups according to disease activity. Clinical characteristics and disease activity score for both SLE and RA patients were assessed. Serum leptin levels [ng/dl] were measured using enzymelinked immunosorbent assay [ELISA]
Results: Both patients with SLE and RA had significantly higher leptin levels than healthy control subjects [38.27 +/- 27.66, 27.73 + 14.58 and 2.73 +/- 0.85 ng/dl respectively; P < 0.0001]. Patients with active SLE showed significantly higher leptin levels in comparison to inactive group [51.57 +/- 35.47 versus 26.62 +/- 10.92 ng/dl; P < 0.0001]. While as, there were no significant difference in serum leptin levels between active and inactive groups of RA patients. Moreover, significant positive correlation was detected between serum leptin levels and degree of proteinuria in lupus nephritis patients. However, no relation could be detected between serum leptin and any of the clinical or laboratory parameters in patients with rheumatoid arthritis
Conclusion: Serum leptin levels significantly increases in both SLE and RA patients, and related to markers of disease activity in SLE but not in RA patients. Moreover, increased serum leptin levels were found to be related to degree of proteinuria in SLE patients. These results suggest that leptin could play a role in the pathogenesis of inflammatory phenomenon and disease activity in patients with systemic lupus erythematosus. While as, the precise role of leptin in rheumatoid arthritis patients remains uncertain, thus further studies including serum and synovial leptin in RA patients are recommended
ABSTRACT
Background: rheumatoid arthritis [RA] is one of the causes of secondary osteoporosis. Several studies showed that patients with R4 have number of risk factors for osteoporosis such as decreased physical activity, duration of disease, steroid use, and disease activity
Objective: to evaluate the bone mineral density in patients with rheumatoid arthritis considering the demographic characteristics of patients, disease activity and different modalities of drug therapy
Setting: department of Medicine, Mansoura Faculty of Medicine, Mansoura
Patients and Methods: the study comprised 87 patients with rheumatoid arthritis and 40 healthy control. All patients had reports about degree of physical activity, smoking habits, daily intake of milk products and history of fractures. Disease activity of RA was considered. All patients and control had BMD evaluated with DEXA
Results: BMD was significantly lower for women with RA compared with males with RA [0.359 +/- 6.89 versus 0.451 +/- 4.06] and in postmenopausal compared with premenopausal women with RA [0.325 +/- 7.57 versus 0.421 +/- 5.66]. Age and cigarette smoking negatively correlated with BMD while daily intake of milk products and daily physical activity showed positive correlation with BMD. All markers of disease activity were negatively correlated with BMD. As regards the drug therapy, BMD did not significantly dipper between treated groups. BMD was reduced in RA patients with history of fracture than in patients without history of fracture, [0.351 +/- 7.25 versus 0.37 +/- 5.38] however, these differences were not statistically significant
Conclusion: BMD loss is greater in RA patients than in sex and age-matched healthy controls. Age, disease activity and lack of physical activity or inadequate intake of milk products are markers to patients at increased risk of osteoporosis