Serum Chemerin Levels May Be a New Biomarker for Women With More Severe RA

Women with rheumatoid arthritis (RA) who have high levels of serum chemerin, an adipokine, were nearly 3 times more likely to have moderate to severe disease severity that women with lower chemerin levels, according to findings from a cross-sectional study published in PLOS ONE.

Women with rheumatoid arthritis (RA) being treated at a hospital in Mexico were included in the study. The investigators assessed patients’ clinical and laboratory data, BMI, fat mass, and ability to perform activities of daily living. They defined RA disease severity according to the Disease Activity Score of 28 Joints and C-reactive protein level (DAS28-CRP). Investigators measured chemerin concentrations by ELISA, with >103 ng/mL considered a high level. Logistic regression analysis was used to determine whether high chemerin levels were associated with RA disease activity, and multiple regression analysis to identify other variables associated with chemerin levels.

Of 210 women included in the study, the mean age was 56 years, mean disease duration was 12 years, 29 patients had diabetes mellitus, and 81 had high blood pressure. It was noted that 42% of patients had moderate to severe disease activity. All patients in the study were being treated with synthetic or biologic DMARDs including 51% receiving combination therapy with 1 or more DMARDs, and 77% of patients were taking glucocorticoids.

There was no significant difference in chemerin levels between RA patients with and without diabetes mellitus.

Women with moderate to severe activity had a higher frequency of functional disability (P <.001) and higher serum chemerin (P =.003) compared with women with low disease activity or remission.

There was a significant positive correlation between serum chemerin levels and swollen joint counts (r =0.15; P =.029), DAS28-CRP (r =0.22; P =.002), and CRP levels (r =0.14; P =.039). There was no correlation found between chemerin levels and BMI or fat mass.

The adjusted logistic regression analysis showed a significant association between high chemerin levels and an increased risk for moderate to severe disease activity (OR, 2.76; 95% CI, 1.35-5.62; P =.005). The multiple regression analysis showed a significant association between chemerin levels and higher DAS28-CRP (P =.002), but not with any other variables.

Study limitations included its exclusion of men and its inability to identify changes in chemerin levels.

“These findings support the hypothesis that serum chemerin levels could be used as a new biomarker to identify patients with a more severe RA without an adequate response to DMARDs,” the study authors wrote.

Reference

Gonzalez-Ponce F, Gamez-Nava JI, Perez- Guerrero EE, Saldaña-Cruz AM, Vazquez-Villegas ML, Ponce-Guarneros JM, et al. Serum chemerin levels: A potential biomarker of joint inflammation in women with rheumatoid arthritis. PLoS ONE. Published online September 10, 2021. doi:10.1371/journal.pone.0255854