The determination of excess of body fat mass provides a more suitable determinant of obesity in rheumatoid arthritis patients; however, body mass index (BMI) may not be accurate for the quantification of adiposity. To identify a marker of excess adiposity in women with rheumatoid arthritis (RA) using different methods for fat mass evaluation. A cross-sectional study was conducted in adult female patients with RA. Disease activity was assessed by DAS28-ESR, and obesity was determined by waist circumference (WC), BMI and dual-energy X-ray absorptiometry (DXA). The Human Bone Metabolism kit (Merck Millipore, Darmstadt, Alemanha) was used to determine the plasma levels of leptin, TNF-α, IL-6, and IL-1β by quantification of serum proteins by technical microspheres (LUMINEX, TX, USA). Adiponectin was measured by enzyme-linked immunosorbent assay sandwich kit (R&D Systems, Minneapolis, MN, USA). Eighty-nine female patients, median age of 55.4 (± 11.6) years, and median disease duration of 16.4 (± 14.9) years were included. The frequency of obesity was 33.7% according to BMI, 89.9% with WC, and 56.1% with DXA. The median serum leptin concentration was the only marker that correlated with body fat percentage according to the three methods. This correlation was positive and not influenced by DAS28, C-reactive protein, erythrocyte sedimentation rate, or inflammatory cytokines levels (IL-6, TNF-α, IL-1β). Analysis of ROC curves determined the cut-off point of 10.3 ng/mL of leptin as an obesity marker, with a sensitivity of 96.43% and a specificity of 23.81%. Serum leptin correlates positively with fat mass and is potentially useful in excess fat mass determination in clinical practice.
Leptin Rheumatoid arthritis Adiposity Body composition
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Adriana Maria Kakehasi received grants from the Fundos de Apoio à Pesquisa da Sociedade Brasileira de Reumatologia.
All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be submitted for publication. MFBRG had full access to all study data and takes responsibility for the integrity of the data. Study conception and design: AMK, MFBRG, and MVMA. Acquisition of data: MFBRG and MRCP. Analysis and interpretation of data: CJM, ELMV, ALTJ, and MFBRG.
Fundos Remanescentes da Sociedade Brasileira de Reumatologia.
Compliance with ethical standards
Conflict of interest
The authors declare they have no conflicts of interest regarding the publication of this paper.
We declare that this study was approved by the Research Ethics Committee of Universidade Federal de Minas Gerais (UFMG) on January 10, 2012 (CAAE-0547.0.203.000-11) and was, therefore, conducted in accordance with the ethical standards set forth in the 1964 Declaration of Helsinki and its subsequent amendments.
All patients gave their informed consent prior to their inclusion in the study. Details that may reveal the identity of the subjects under study have been omitted.
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