AB1108

LEPTIN CONCENTRATIONS AND RADIOLOGICAL PROGRESSION IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

A. Zygmunt ^1,*A. Brzeska ²J. Lipinska ¹J. Stanczyk ¹E. Smolewska ¹

¹Department Of Pediatric Cardiology And Rheumatology, Medical University Of Lodz, Maria Konopnicka Memorial Hospital, ²Emergency Room, Maria Konopnicka Memorial Hospital, Lodz, Poland

Background: In recent years it has been found that leptin is not only involved in the nutritional processes of the organism but it is also a modulator of inflammatory and immune response. However the precise nature of its role in inflammatory diseases is unknown (1-4). It has been reported that leptin substitution might have protective effect on bones in septic arthritis (5).

Objectives: The aim of the study was to assess if there is a correlation between leptin concentrations and radiological progression in children with juvenile idiopathic arthritis (JIA).

Methods: Study population comprised 26 children with JIA (17 girls – 65% and 9 boys – 35%), of whom 16 (62%) had oligoarticular type of the disease, 8 (31%) – polyarticular type and the rest – systemic. The activity of the disease was high in 10 patients, moderate in 4 and low in 12. The level of leptin was evaluated by ELISA method in the blood serum and additionally in 14 patients who had had joint puncture in synovial fluid. The radiological status of a child was scored twice according to the Steinbrocker scale score.

Results: The mean serum leptin level in our patients was 15.72 ng/mL (range between 0.02 and 81.65 ng/mL), whereas mean synovial fluid leptin concentration was 22.93 ng/mL (range between 1.07 and 80.81 ng/mL). At the baseline 12 out of 26 children (46%) were assessed to have I^st score in the Steinbrocker scale, 7 (27%) - II^nd score and 7 (27%) - III^rd score. After follow-up (mean follow-up period – 28 months), 9 patients (35%) had I^st score in the Steinbrocker scale, 10 (38%) - II^nd score, 5 (19%) - III^rd score and and 2 - IV^rd score. The progression in radiological status took place in 7 patients, all of whom had low levels of leptin (0.02-4.24 ng/mL). Two girls had slight improvement in their radiological status, the rest of the group remained at the same Steinbrocker score. None of the children with JIA with leptin level over 15 ng/mL had progression on the radiographs according to the Steinbrocker scale.

Conclusions: Leptin levels were lower in children with radiological progression of the disease, which might indicate that this molecule has protective influence on joint destruction in children with JIA.

References: 1. Targonska-Stepniak B, Majdan M, Dryglewska M. Leptin serum levels in rheumatoid arthritis patients: relation to disease duration and activity. Rheumatol Int 2008;28:585-91.

2. Lee SW, Park MC, Park YB, Lee SK. Measurement of the serum leptin level could assist disease activity monitoring in rheumatoid arthritis. Rheumatol Int 2007;27:537-40.

3. Popa C, Netea MG, Radstake TR, van Riel PL, Barrera P, van der Meer JW. Markers of inflammation are negatively correlated with serum leptin in rheumatoid arthritis. Ann Rheum Dis 2005; 64:1195-98.

4. Bokarewa M, Bokarew D, Hultgren O, Tarkowski A. Leptin consumption in the inflamed joint of patients with rheumatoid arthritis. Ann Rheum Dis 2003; 62:952-56.

5. Hultgren OH, Tarkowski A. Leptin in septic arthritis: decreased levels during infection and amelioration of disease activity upon its administration. Arthritis Res 2001; 3:389-94.

Disclosure of Interest: None Declared