leptin and Polymyalgia-Rheumatica

Topics: Adiponectin; Aged; Aged, 80 and over; Ankle Brachial Index; Aorta, Abdominal; Cardiovascular Diseases; Carotid Artery, Common; Carotid Intima-Media Thickness; Case-Control Studies; Comorbidity; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Hypercholesterolemia; Leptin; Male; Middle Aged; Overweight; Peripheral Arterial Disease; Polymyalgia Rheumatica; Resistin; Risk Factors; Smoking; Ultrasonography, Doppler, Color; Vascular Stiffness

This study is concerned with an evaluation of the effects of glucocorticoids (GC) on adiponectin and leptin concentrations in patients with polymyalgia rheumatica (PMR). Seven patients diagnosed with PMR were studied at baseline and after one and three months of prednisone treatment. Serum leptin and adiponectin, serum glucose and insulin, erythrocyte sedimentation rate, C-reactive protein, and IL-6 were all measured by commercial assays. The treatment with GC normalized inflammation markers and significantly increased adiponectin and leptin concentrations without any impairment of insulin sensitivity measured by HOMA-IR. Adiponectin significantly increased only between baseline and 1 month (P= 0.013). A significant correlation was found between adiponectin and leptin concentrations both at baseline and after 3 months of treatment (both rho = 0.89, P= 0.03). In addition, adiponectin correlated also with serum glucose at baseline (rho = 0.81, P= 0.047). According to our results, adiponectin concentrations seem to be driven by inflammation, whereas leptin seems to be increased directly by the use of steroids.

Topics: Adiponectin; Aged; Aged, 80 and over; Blood Glucose; Blood Sedimentation; C-Reactive Protein; Dose-Response Relationship, Drug; Female; Glucocorticoids; Humans; Insulin; Interleukin-6; Leptin; Male; Middle Aged; Pilot Projects; Polymyalgia Rheumatica; Prednisone

To evaluate the insulin sensitivity (IS) and levels of peptides with impact on IS in polymyalgia rheumatica (PMR) before and after prednisolone treatment.. Fifteen PMR patients and 15 controls were included. Subjects were studied before and after treatment with prednisolone for 14 days (20 mg/day). Composite IS indices were calculated from glucose and insulin concentrations during an oral glucose tolerance test (OGTT). Plasma concentrations of tumour necrosis factor alpha (TNF), interleukin (IL)-6, IL-8, monocyte chemoattractant protein 1 (MCP-1), resistin, leptin, and adiponectin were measured.. Prednisolone abolished symptoms and increased physical activity within 1–2 days; erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were normalized at day 14. Before treatment, IS was lower in patients vs. controls (p < 0.001). Following treatment, IS was restored in patients (p < 0.01) but not changed in controls (p > 0.05). IL-6, TNF, and IL-8 were higher in patients vs. controls before treatment (p < 0.05–0.001), and decreased after treatment in patients (p < 0.001) but did not change in controls. Before treatment, adiponectin was lower in patients vs. controls (p < 0.05). During treatment, adiponectin increased in both groups (p < 0.05). Leptin did not differ between untreated patients and controls but increased in both groups (p < 0.05). MCP-1 and resistin did not differ (p > 0.05).. IS is decreased in PMR, probably reflecting abnormal cytokine and adipokine levels. Treatment with prednisolone improves IS along with normalization of cytokine and adipokine levels and physical activity.

Topics: Adiponectin; Aged; Aged, 80 and over; Blood Glucose; Case-Control Studies; Chemokine CCL2; Chemokines; Cytokines; Female; Glucocorticoids; Humans; Insulin; Insulin Resistance; Interleukin-6; Interleukin-8; Leptin; Male; Middle Aged; Motor Activity; Polymyalgia Rheumatica; Prednisolone; Resistin; Tumor Necrosis Factor-alpha