Adipokines and Cytokines
Table 2 shows the comparison of cytokines and adipokines between HD and the whole SSc cohort. Leptin and resistin were significantly higher in SSc than in HD. Visfatin was also increased in SSc, but the difference from HD did not reach the statistically significance. Adiponectin was measured only in the SSc group (see below). Remarkably, SSc patients showed significantly higher levels of TNFα and IL-2 than HD. Because of a possible bias by drugs, serum levels of cytokines and adipokines were correlated to the different treatments by multiple linear regression models. To this end, patients were grouped into SSc-glucocorticoids, SSc-ERA, SSc-immunosuppressants, SSc-CCB, SSc-iloprost, SSc-PDE5i. Only PDE5 inhibitors were independently associated with higher levels of leptin (OR 3.27, 95% CI 12892-52716, p=0.002) and visfatin (OR 2.66, 95% CI 4340-29950, p=0.009). Therefore, SSc patients were stratified into those taking PDE5i and those who did not, and compared by cytokines and adipokines levels (Table 2). Although only 8 SSc patients were on treatment with PDE5i, their levels of leptin and visfatin were significantly higher than in SSc patients without PDE5i (Table 2), while no difference was detected of the remaining cytokines.
No statistically significant difference in cytokines/adipokines levels between early SSc (<2 years of disease duration) and late disease (>2 years of disease duration) was observed. We also stratified SSc patients as high and low CV risk according to the Framingham score and other indices (cholesterol /HDL ratio >4.5, waist circumference >88 cm, WHR >0.8). As only 3 patients had high/medium CV FRS, statistical comparison with those showing low risk CV FRS could not be made (data not shown). Furthermore, no significant differences were found when patients were stratified according to DLCO ​​<75% or FVC <70% values, or the disease activity index ESSG < 3. Likewise, no peculiar pattern of cytokines/adipokines was found in lcSSc or dcSSc subsets.