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Serum adipokine levels and associations with patient-reported fatigue in systemic lupus erythematosus

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Abstract

Physical activity ameliorates fatigue in systemic lupus erythematosus (SLE) patients by an unknown mechanism. Adipokines, which are influenced by adiposity and physical activity, may be associated with patient-reported fatigue. We describe cross-sectional associations between adipokines and fatigue, physical activity, and SLE disease activity. We measured adipokines, self-reported fatigue, and objective physical activity in 129 SLE patients. Fatigue was assessed with the Fatigue Severity Scale (FSS) and Patient Reported Outcomes Measurement Information System® (PROMIS®) Fatigue score. Disease activity was measured with the Safety of Estrogens in Systemic Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI). Participants wore an accelerometer for 7 days to measure physical activity. Leptin, adiponectin, and resistin were measured in stored serum with a Luminex bead-based assay. Multivariable regression models assessed relationships between fatigue and adipokines, and Spearman correlation coefficients summarized associations between adipokines, physical activity, and SELENA-SLEDAI. Median adipokine levels were: leptin 30.5 ng/ml (Interquartile Range 14.0, 56.6), adiponectin 11.6 μg/ml (7.2, 16.8) and resistin 1.4 ng/ml (1.0, 2.2). Associations between adipokines and FSS or PROMIS fatigue were not significant. Body mass index (BMI) ≥ 30 kg/m2 was associated with FSS and PROMIS fatigue in regression analyses (p < 0.05). Weak correlations between leptin, adiponectin, leptin/adiponectin (L/A) ratio, and physical activity and between adiponectin and SELENA-SLEDAI score were not significant after adjusting for BMI. Adipokines were not associated with fatigue in SLE. Adipokines were correlated with physical activity (leptin, adiponectin, L/A ratio) and SLE disease activity (adiponectin), but most of these associations were explained by BMI.

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Acknowledgements

The authors wish to thank Carla Cuda Ph.D. and Harris Perlman Ph.D. for their assistance with the Luminex assay for adipokine measurement.

Funding

This work was supported by National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases (R21AR059989, T32AR007611); Northwestern University Multidisciplinary Clinical Research Center in Rheumatology (P60AR064464); and the Northwestern University Clinical and Translational Sciences Institute (UL1TR000150).

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Authors and Affiliations

  1. Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 240 East Huron Street M-300, Chicago, IL, 60611, USA

    Mary A. Mahieu, Grace E. Ahn, Dorothy D. Dunlop, Rowland W. Chang & Rosalind Ramsey-Goldman

  2. Arthritis and Rheumatism Associates, Wheaton, MD, USA

    Grace E. Ahn

  3. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Joan S. Chmiel, Irene B. Helenowski & Rowland W. Chang

  4. Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Dorothy D. Dunlop, Jing Song & Rowland W. Chang

  5. Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, IL, USA

    Pamela Semanik

  6. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Susan Yount

  7. Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Rowland W. Chang

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  1. Mary A. Mahieu
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  2. Grace E. Ahn
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Correspondence to Mary A. Mahieu.

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Mahieu, M.A., Ahn, G.E., Chmiel, J.S. et al. Serum adipokine levels and associations with patient-reported fatigue in systemic lupus erythematosus. Rheumatol Int 38, 1053–1061 (2018). https://doi.org/10.1007/s00296-017-3924-x

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