Circulating Visfatin And Resistin Levels In Patients With Rheumatoid Arthritis And Their Correlation With Disease Activity:a Meta-analysis

Objective:Obesity is an independent risk factor for rheumatoid arthritis(RA),suggesting that fat metabolism is involved in the pathogenesis of RA.Visfstin and resistin are cytokine-like adipokines secreted by adipocytes,which can effectively regulate inflammation and immune response,and are closely related to the inflammatory disease activities of RA.There are many studies on circulating visfstin and resistin levels in patients with rheumatoid arthritis at home and abroad,but the relationship between visfatin or resistin levels and rheumatoid arthritis is still controversial.This study aims to systematically evaluate the levels of serum visfstin and resistin in patients with RA,and to reveal the relationship between the levels of the two adipokines and RA disease activity.Methods:According to the inclusion and exclusion criteria,the search terms were rheumatoid arthritis,adipokine,visfatin,resistin and Rheumatoid arthritis,adipocytokine,Pre-B cell colony-enhancing factor,PBEF,visfatin,resistin,etc.We search study in Dutch medical abstracts(EMBASE/SCOPUS),Medical library biomedical information retrieval system(PubMed),Web of science database,China Knowledge Network China Knowledge Infrastructure Project(CNKI),Wanfang database about the serum/plasma visfatin or resistin levels in rheumatoid arthritis patient and their correlation with disease activity score(DAS28)or C-reactive protein.Newcastle-Ottawa scale(NOS)and STATA12.0statistical software were used for literature quality evaluation and Meta analysis.Outcome indicators are expressed as standard mean difference,95%confidence interval and correlation coefficient.After excluding the single studies with the greatest impact one by one,the sensitivity analysis was performed by comparing the changes of the remaining combined effect with the total effect.Secondly,perform subgroup analysis based on the characteristics of the participants to find potential sources of heterogeneity.Use funnel chart and Egger linear regression to qualitatively/quantitatively assess whether there is publication bias.Results:A total of 15 high-quality(NOS score?6)articals were obtained,inciuding 1050RA patients and 776 normal controls.There was heterogeneity(I~2>50%)between studies,so meta-analysis was conducted by random effects model.The results showed that the serum/plasma visfatin levels were significantly higher in the RA group than in the control group,and the difference was statistically significant[(SMD=1.86,95%CI(1.16,2.55),P<0.05)].A trend of positive correlation among Serum/plasma visfatin levels and DAS28and CRP levels was found[correlation coefficient=0.223,95%CI(0.141,0.303),P<0.05];[correlation coefficient=0.163,95%CI(0.051,0.270),P<0.05].The serum/plasma resistin levels were significantly higher in the RA group than in the control group[SMD=0.720,95%CI(0.205,1.234),P<0.05].Serum/plasma resistin level was not associated with DAS28 and CRP levels[correlation coefficient=0.002,95%CI(-0.083,0.088),P=0.955];[correlation coefficient=-0.083,95%CI(-0.190,0.026),P=0.137].Sensitivity analysis suggests that each study has no significant effect on the overall combined effect,and the results of this Meta analysis have good stability.Subgroup analysis suggested that areas,age,sex,BMI,and duration of disease are not the heterogeneous source of RA circulating visfatin levels,and age,gender,and BMI may be the heterogeneous sources of RA circulating resistin levels.The funnel plot is roughly symmetrical,and Egger linear regression suggests that the included articles have no significant publication bias(P>0.1).Conclusion:The circulating visfatin levels and resistin were higher in patients with RA than in controls.Circulating visfatin levels are positively correlated with RA activity.More large-scale studies are needed to explore the relationship between adipokines and RA.