Rheumatology International

, Volume 38, Issue 6, pp 1053–1061 | Cite as

Serum adipokine levels and associations with patient-reported fatigue in systemic lupus erythematosus

  • Mary A. MahieuEmail author
  • Grace E. Ahn
  • Joan S. Chmiel
  • Dorothy D. Dunlop
  • Irene B. Helenowski
  • Pamela Semanik
  • Jing Song
  • Susan Yount
  • Rowland W. Chang
  • Rosalind Ramsey-Goldman
Observational Research


Physical activity ameliorates fatigue in systemic lupus erythematosus (SLE) patients by an unknown mechanism. Adipokines, which are influenced by adiposity and physical activity, may be associated with patient-reported fatigue. We describe cross-sectional associations between adipokines and fatigue, physical activity, and SLE disease activity. We measured adipokines, self-reported fatigue, and objective physical activity in 129 SLE patients. Fatigue was assessed with the Fatigue Severity Scale (FSS) and Patient Reported Outcomes Measurement Information System® (PROMIS®) Fatigue score. Disease activity was measured with the Safety of Estrogens in Systemic Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI). Participants wore an accelerometer for 7 days to measure physical activity. Leptin, adiponectin, and resistin were measured in stored serum with a Luminex bead-based assay. Multivariable regression models assessed relationships between fatigue and adipokines, and Spearman correlation coefficients summarized associations between adipokines, physical activity, and SELENA-SLEDAI. Median adipokine levels were: leptin 30.5 ng/ml (Interquartile Range 14.0, 56.6), adiponectin 11.6 μg/ml (7.2, 16.8) and resistin 1.4 ng/ml (1.0, 2.2). Associations between adipokines and FSS or PROMIS fatigue were not significant. Body mass index (BMI) ≥ 30 kg/m2 was associated with FSS and PROMIS fatigue in regression analyses (p < 0.05). Weak correlations between leptin, adiponectin, leptin/adiponectin (L/A) ratio, and physical activity and between adiponectin and SELENA-SLEDAI score were not significant after adjusting for BMI. Adipokines were not associated with fatigue in SLE. Adipokines were correlated with physical activity (leptin, adiponectin, L/A ratio) and SLE disease activity (adiponectin), but most of these associations were explained by BMI.


Systemic lupus erythematosus Adipokines Fatigue Physical activity 



The authors wish to thank Carla Cuda Ph.D. and Harris Perlman Ph.D. for their assistance with the Luminex assay for adipokine measurement.


This work was supported by National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases (R21AR059989, T32AR007611); Northwestern University Multidisciplinary Clinical Research Center in Rheumatology (P60AR064464); and the Northwestern University Clinical and Translational Sciences Institute (UL1TR000150).

Compliance with ethical standards

Conflict of interest

None of the authors have conflicts of interest to disclose.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Rheumatology, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Arthritis and Rheumatism AssociatesWheatonUSA
  3. 3.Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Center for Healthcare Studies, Institute for Public Health and MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  5. 5.Department of Adult Health and Gerontological NursingRush University College of NursingChicagoUSA
  6. 6.Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoUSA
  7. 7.Department of Physical Medicine and RehabilitationNorthwestern University Feinberg School of MedicineChicagoUSA

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