leptin and Arthritis--Juvenile

Objective To assess possible changes in leptin and ghrelin secretion due to etanercept in juvenile idiopathic arthritis (JIA). Methods 50 patients with JIA and 16 age-matched controls were enrolled into this prospective, cross-sectional study. Serum leptin, total and acyl ghrelin were measured in addition to white blood cell (WBC) and lymphocyte counts. Results 25 patients received etanercept and 25 conventional therapies (including methotrexate) for JIA. There was no difference between treatment and control groups in leptin or ghrelin levels and no evidence of a relationship between leptin and ghrelin in patients with JIA. In all children with JIA there was a correlation between leptin and body mass index (BMI). However, compared with children in the conventional treatment group, children in the etanercept group showed a positive correlation between total ghrelin and BMI and those with a low BMI showed a negative correlation between acyl ghrelin and BMI. Conclusion No differences in leptin and ghrelin concentrations were found when patients with JIA and controls were compared or when patients who received etanercept were compared with those who received conventional treatment for JIA.

Topics: Adolescent; Antirheumatic Agents; Arthritis, Juvenile; Body Mass Index; Case-Control Studies; Child; Cross-Sectional Studies; Etanercept; Female; Ghrelin; Humans; Leptin; Lymphocyte Count; Male; Methotrexate; Prospective Studies

Leptin regulates the organism's immune response. Juvenile idiopathic arthritis (JIA) is a chronic joint disease in children, leading to chronic changes in motor organs.. In children with JIA (n = 42) and healthy subjects (n = 28), leptin concentration (LEP), body mass index (BMI), haematocrit (HTC), haemoglobin (HB), morphotic elements (WBC,LYMPH), erythrocyte sedimentation rate (ESR), and ANA Hep-2 antibodies were analysed. JIA group was divided into: children with a longer (51-148 months) (IA) n = 22 and a shorter disease period (2-18 months) (IB) n = 20.. Only 58.3% of the IA and 50% of the IB group had ANA Hep-2 confirmed. The ill children had higher and more diversified LYMPH and ESR levels compared to the healthy children. The highest LEP for the IA group was 37.5 ng/cm3, (Me 5.85), for IB - 40.10 ng/cm3, (Me 2.46) as compared to the IC - 3.74 ng/cm3 (Me 2.85), respectively. The average BMI value for the IA group was 16.61 kg/m2, for IC it was 18.91 kg/m2, and the median for IB was 15.89 kg/m2. Children with BMI values < 23 kg/m2 from the IA and IB group had a reduction in LEP as compared to control group (p = 0.04). The relationship between the illness and LEP diversification per BMI unit was found in both groups. Children with a shorter illness period had higher LEP differentiation per BMI unit compared to the healthy children.. Children with juvenile idiopathic arthritis with BMI < 23 kg/m2 had lower leptin concentrations than healthy subjects. Ill children with a shorter-term disease had a higher diversification of leptin concentration per BMI unit as compared to healthy controls.

Topics: Adolescent; Arthritis, Juvenile; Body Mass Index; Child; Child, Preschool; Female; Humans; Leptin; Male

To evaluate interactions between skeleton and adipose tissue, and association of adipokines and bone turnover markers with disease-related factors in patients with severe juvenile idiopathic arthritis (JIA).. Forty-nine patients (median age 14.8 yrs, median disease duration 10.2 yrs) with refractory polyarticular JIA and 89 sex-matched and age-matched healthy controls participated in the study. Study subjects underwent clinical examination, body composition assessment with dual-energy X-ray absorptiometry, and analyses for leptin, adiponectin, and bone turnover markers.. Patients with JIA were shorter and more often overweight (p = 0.001) or obese (p < 0.001) than controls. They had significantly higher serum leptin, even when adjusted for fat mass (p < 0.001), than did controls. Adiponectin did not differ between the groups. Concentration of carboxyterminal telopeptide of type I collagen was higher (p = 0.006) in patients. The inverse association between leptin and bone turnover markers disappeared in controls but was strengthened in patients when adjusted for fat mass. Leptin, adiponectin, or bone markers did not associate with variables of disease activity.. Patients with severe JIA had high adiposity accompanied by increased bone resorption. Their serum leptin was higher, even independently of fat mass. Leptin tended to associate inversely with bone turnover markers but did not associate with variables of disease activity.

Topics: Adipokines; Adiponectin; Adipose Tissue; Adiposity; Adolescent; Arthritis, Juvenile; Biomarkers; Body Mass Index; Bone and Bones; Bone Density; Bone Resorption; Case-Control Studies; Child; Collagen Type I; Female; Humans; Leptin; Male; Peptide Fragments; Peptides; Procollagen; Severity of Illness Index

This study was done to evaluate the relation between the level ofleptin, prolactin, IL-4 and IL-5 with the activity of Rheumatoid Arthritis (RA) and Lupus erythematosus (SLE). The study included 33 patients divided into two groups. Group 1 included twenty-one patients with Juvenile rheumatoid arthritis (13 males and 8 females) with age 11.9 +/- 3.6 years and twelve patients with systemic lupus erythematosus were enrolled as group 2 (2 males and 10 females) with age 15.8 +/- 2.9 years. Twenty-one healthy children with matched age, sex and anthropometrics measures were included in the study to serve as control group (group 3). There were significant increases in the levels of Leptin (<0.038), Prolactin (p < 0.021) IL-4 (p < 0.005) in Juvenile Rheumatoid Arthritis group with insignificant decrease in IL-5 (p < 0.724) in comparison to control group. Systemic Lupus group show a significant increase in level of Leptin (p < 0.05), Prolactin (p < 0.02) and IL-4 (p < 0.000) with an insignificant increase in IL-5 (p < 0.685) in comparison to control group. RA patients show a positive significant correlation between Prolactin, IL-5 and activity with negative insignificant correlation between IL-4 and activity. Where in Lupus patients there was a positive significant correlation between Prolactin, IL-4 and activity with negative insignificant correlation between IL-5 and activity. There was no correlation between Leptin and activity in both diseases (RA, SLE). There's a highly significant positive correlation between serum Leptin levels and BMI among all patients of RA and Lupus (p < 0.000, p < 0.003), respectively. There was a difference in the Leptin level between male and female patients with a significant increase in the female than male (p < 0.05). We can conclude from our results that Leptin cannot be used to assess disease activity in RA and SLE where Prolactin can be used to assess disease activity in RA and SLE.

Topics: Adolescent; Arthritis, Juvenile; Biomarkers; Body Mass Index; Case-Control Studies; Child; Female; Humans; Interleukin-4; Interleukin-5; Leptin; Lupus Erythematosus, Systemic; Male; Prolactin; Sex Characteristics

Weight loss is common in juvenile idiopathic arthritis (JIA) and has been positively correlated with an increase in the production of proinflammatory cytokines.. To assess if plasma leptin is a mediator of cytokine dependent decreased food intake during inflammatory diseases and if it is increased in JIA.. Leptin levels were determined in 31 patients with polyarticular disease and in 37 with oligoarticular disease; 32 healthy children served as controls.. Patients had significantly reduced body mass index (BMI) compared with controls (17.3 (3) v 19.1 (3) kg/m(2); p<0.005). Leptin was significantly lower in patients than controls (8.1 (4.8) v 10.7 (7.3) ng/ml; p = 0.036), but leptin/BMI values were similar. Absolute (8.2 (4.8) v 8 (4.9); p>0.05) and normalised (0.45 (0.24) v 0.47 (0.24); p>0.05) leptin levels were not significantly different between patients with active and inactive disease and between patients with oligoarticular and polyarticular arthritis (7.8 (4.4) v 8.6 (5.3); p>0.05 and 0.45 (0.23) v 0.48 (0.26); p>0.05, respectively).. Leptin production per unit of fat mass is similar in patients and controls. The hypothesis that high levels of proinflammatory cytokines that characterise JIA might induce an increase of adipocytes leptin production is not supported by the results. Leptin may be a marker of nutritional status of JIA.

Topics: Adipocytes; Adolescent; Anthropometry; Arthritis, Juvenile; Biomarkers; Body Mass Index; Child; Female; Humans; Leptin; Male; Nutritional Status