THU0088 BASELINE ADIPONECTIN LEVELS PREDICT FUTURE DEVELOPMENT OF RHEUMATOID ARTHRITIS IN SUBJECTS WITH OBESITY

Background: Adiponectin is a cytokine produced by the adipose tissue and is involved in both metabolic and inflammatory processes1. In obese subjects, serum adiponectin levels are surprisingly low2. On the contrary, adiponectin levels are increased in serum and synovial fluid of subjects with established rheumatoid arthritis (RA)1,3. Objectives: By exploiting a longitudinal study enrolling more than 4000 obese subjects, we aim to determine if serum adiponectin levels are a risk factor for the development of RA in obese subjects. Methods: The Swedish Obese Subjects (SOS) study is a longitudinal controlled trial on the effect of bariatric surgery on the incidence of obesity-related diseases. It includes 4047 obese subjects whereof 2010 underwent bariatric surgery and 2037 constituted the matched control group4,5. SOS study participants who developed RA were identified by searching the Swedish National Patient Register. Eleven subjects with prevalent RA at baseline are excluded by the analyses. Patients were followed up until diagnosis of RA, death, migration or end of follow-up (December 2016). Total adiponectin was measured using the Quantikine ELISA kit from Quantikine ELISA kit from Bio-Techne (Minneapolis, MN, USA). Results: Adiponectin measurement at baseline was available for 3691 subjects. Among those subjects, 82 subjects developed RA during a follow up for up to 29 years. High serum adiponectin levels at baseline were associated with the incidence of RA, independently of bariatric surgery, sex, age, body-mass index, smoking, and C-reactive protein and erythrocyte sedimentation rate levels (adjusted Hazard Ratio HR per 10 µg/mL adiponectin 1.70, 95% confidence interval CI 1.12-2.60, P value=0.01). When stratifying the population according to the median of baseline adiponectin, subjects with adiponectin greater than 6.8 µg/mL had a higher risk to develop RA during follow up (log-rank P 0.028, unadjusted HR 1.64, 95% CI 1.05-2.56, P=0.03, Figure 1). Conclusion: In a large cohort of obese subjects followed up for up to 29 years, serum adiponectin levels were associated with the incidence of RA years before the onset of clinical signs. The association between adiponectin and the incidence of RA was independent of other risk factors, including C-reactive protein, smoking and bariatric surgery. References: [1] Fantuzzi G. Adiponectin in inflammatory and immune-mediated diseases. Cytokine 2013;64:1-10. [2] Hotta K, Funahashi T, Arita Y, et al. Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol 2000;20:1595-9. [3] Lee YH, Bae SC. Circulating adiponectin and visfatin levels in rheumatoid arthritis and their correlation with disease activity: A meta-analysis. Int J Rheum Dis 2018;21:664-72. [4] Sjöström L, Larsson B, Backman L, et al. Swedish obese subjects (SOS). Recruitment for an intervention study and a selected description of the obese state. Int J Obes Relat Metab Disord 1992;16:465-79. [5] Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741-52.Abstract THU0088 – Figure 1 Cumulative incidence of RA in the SOS study stratified by baseline adiponectin Disclosure of Interests: Cristina Maglio: None declared, Yuan Zhang: None declared, Christian Herder Speakers bureau: Eli Lilly, Sanofi-Aventis Deutschland, Anna Rudin Grant/research support from: I have received research grants från AstraZeneca (2017-2018), Consultant for: I was paid consultant för AstraZeneca (2015-2018), Lena Carlsson Consultant for: I have received lecture fees from AstraZeneca, MSD and Johnson&Johnson