Serum leptin concentration, bone mineral density and bone biochemical markers in a sample of Egyptian women: a possible relationship

Adipocytokines secreted by adipose tissue participate in bone metabolism; leptin is one of the circulating peptides secreted by adipose tissue. To determine the serum levels of leptin in obese postmenopausal women in order to correlate these levels with bone mineral density and bone biochemical markers to find out the role of leptin in bone metabolism. This was a cross-sectional study which included 37 obese postmenopausal women with body mass index [BMI] >30 kg/m[2]. Thirty-seven lean postmenopausal women with BMI <25 kg/m[2] were included as control group. Serum leptin, bone specific alkaline phosphatase [BAP], osteocalcin and urine C-telopeptide of type collagen [CTx] were assayed. Bone mineral density [BMD] and soft tissue body composition were determined using dual energy X-ray absorptiometry. There was a statistically highly significant increase in serum leptin levels in obese than lean postmenopausal women [p < 0.0001]. There was a highly significant decrease in BMD of spine and hip [p < 0.0001] in obese than lean postmenopausal women. After adjustment of fat mass, a highly significant positive correlation was found between leptin and BAP [r = 0.562, p < 0.0001], a significant positive correlation was found between leptin and each of osteocalcin and urine CTx [r = 0.423, 0.456 respectively, p < 0.05] but there was no statistically significant correlation between leptin and BMD. Our results support the hypothesis that leptin can act directly or indirectly on bone remodeling by modulating osteoblast activities. Leptin was found to be associated with decreased BMD at different sites of the body and was positively correlated with bone biochemical markers. However, leptin did not come out to be an independent predictor of BMD whereas; fat mass was found to have a role in bone metabolism in postmenopausal women. However these comparisons of a single measurement of leptin with BMD, does not exclude possible long-term strong relationships between leptin and BMD

Correlation between old and new immuno-inflammatory markers and disease activity in systemic lupus erythematosus

To compare new SLE activity inflammatory markers with traditional ones. In addition, to correlate those with disease activity index of SLE. Forty-three patients fulfilling the American College of Rheumatology criteria for diagnosis of SLE and 20 apparently healthy controls were subjects for study. Neopterin, soluble intercellular adhesion molecule [sICAM-1] and soluble vascular cell adhesion molecule [sVCAM-1] were measured as well as anti-dsDNA antibodies, C3, C4 and CRP. The British Isles Lupus Assessment Group [BILAG] disease activity index was used to measure disease activity. Twenty-four [55.8%] patients had active SLE [total BILAG score > 5], involving more than one system in nine [37.5%]. Activity was more in musculoskeletal, mucocutaneous, and hematological systems. All markers showed significant differences between SLE patients and controls. Neopterin, sVCAM and CRP were highest when compared to controls [p>0.001] as well as to inactive subgroup. The level of sICAM-1 in active was insignificantly higher than inactive group. Significant correlations were found between total BILAG score and CRP, neopterin, sVCAM. No positive correlation was found between any marker and disease activity of different BILAG organ systems. All tests were done for 22 patients on 3 occasions over 6 months. Highest levels of sVCAM-1 were in active subgroup with flares during the first measurement. Significant decrease between first and third measurement was observed within all subgroups. Neopterin and sVCAM-1 appear to be clinically useful for isolated and serial concentrations assessments of SLE disease activity scored using the BIIAG index. Anti-dsDNA and sVCAM-1 are good markers to predict remission

Antikeratin antibodies and antiperinuclear factor as diagnostic criteria for rheumatoid arthritis

Various auto-antibodies have been described in the serum of rheumatoid arthritis [RA] patients, such as rheumatoid factor [RF], Antiperinuclear factor [APF] and antikeratin antibodies [AKA]. The aim of this study was to evaluate the association of AKA with the activity and severity of RA. Also, to assess their diagnostic value in relation to RF and APF, as well as to determine whether measurements of these antibodies are useful to distinguish early RA from other inflammatory connective tissue disorders. One hundred and ten serum samples from connective tissue [CT] disorders patients who were diagnosed according to the American College of Rheumatology [ACR] criteria were enrolled in this study. They included 68 RA and 42 different rheumatic disorders. They were tested along with 30 serum samples from apparently healthy subjects. AKA and APF were detected with the indirect immunofluorescence [IIF] technique. RF was estimated with latex fixation test [LFT] and then titrated with Rose Waaler test [RW]. Detection of erythrocyte sedimentation rate [ESR] and C reactive protein [CRP] were used as disease activity parameters. Hands and wrists x-ray films were obtained from all RA patients for joint damage evaluation. A positive AKA test was found in 48.5% of RA patients and turned to be highly specific for RA cases [disease specificity 95.8%]. RF and APA were more sensitive than AKA in detection of RA [78% and 58.8% respectively] but less specific [83.3% and 90.2% respectively]. RF positivity [>1:128] was restricted to RA but occurred only in 39.6% of sero-positive RA cases. AKA fluorescence intensity grade 2 and 3 occurred only in RA patients and in 57.5% of AKA -positive RA cases. APF titer >1:20 was restricted to RA and occurred in 42.5% of APF-positive RA cases. No significant differences were found between RA positive and negative cases of AKA, APF or RF as regards the age or the disease duration. While significant differences were found when positive and negative cases of AKA and RF were compared as regards the ESR, CRP and radiographic changes. A significant positive correlation was found between the degree of positivity of AKA and RF titers. Moreover, a significant positive correlation was found between the degree of positivity of AKA levels and ESR and CRP levels, and also with the radiographic changes