The association between clinically suspect arthralgia and adipokines in obese patients.

Objective: Obesity is a moderate low-grade chronic inflammatory condition. The cause of low-grade inflammation in obese patients who have clinically suspect arthralgia (CSA) may be the subject of debate in clinical practice. Our aim is to determine whether inflammation is associated with obesity or rheumatic disease, and the association between leptin, chemerin, visfatin and inflammatory markers in obese patients with/without musculoskeletal symptoms.

Methods: Seventy-four obese patients who admitted to our rheumatology clinic with CSA were enrolled. The control group consisted of 40 obese patients who have no rheumatic symptoms. Body mass index (BMI) was calculated in kg/m2 with body weight ratio to height squared, and obesity was defined as BMI 30 or above. Age, gender, BMI, waist and hip circumferences, waist-to-hip ratio (WHR), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), interleukin-1 beta (IL-1β), leptin, chemerin, and visfatin were evaluated. The relationship between all parameters was assessed by Spearman correlation, Wilcoxon Signed-rank, and paired t-tests.

Results: There were no significant differences for age, gender, ESR and CRP between obese patients with CSA and control group. The mean TNF-α, IL-1β, IL-6 concentrations were 60.8 pg/mL, 39.9 pg/ml, and 26.2% in obese patients with CSA, respectively. ESR, CRP, TNF-α, IL-6, and IL-1β concentrations were higher in these patients compared to obese patients without any rheumatic symptoms. The mean WHR and waist circumference were 0.8±0.1 and 107.1±13.4 cm, respectively in patients with CSA. IL-6 correlated with WHR and waist circumference, positively. There were significant differences for adipokines such as chemerin, visfatin, but not for leptin between both group. Moreover, a significant correlation was found between pro-inflammatory cytokines and visfatin, chemerin.

Conclusion: Visfatin and chemerin correlated with inflammation and may be useful indicators of undifferentiated inflammatory arthritis in obese patients with CSA.