Ann. N.Y. Acad. Sci. ISSN 0077-8923 ANNALS OF THE NEW YORK ACADEMY OF SCIENCES Issue: Neuroendocrine Immunology in Rheumatic Diseases Changes in adiponectin and leptin concentrations during glucocorticoid treatment: a pilot study in patients with polymyalgia rheumatica M. A. Cimmino, 1 G. Andraghetti, 2 L. Briatore, 2 B. Salani, 2 M. Parodi, 1 M. Cutolo, 1 and R. Cordera 2 1 Clinica Reumatologica, Dipartimento di Medicina Interna, 2 Clinica Malattie del Metabolismo e Diabetologia, Dipartimento di Scienze Endocrine e Mediche, Universit ` a di Genova, Genova, Italy Address for correspondence: Marco A. Cimmino, M.D., Clinica Reumatologica, Dipartimento di Medicina Interna, Universit` a di Genova, Viale Benedetto XV, 6, 16132 Genova, Italy. cimmino@unige.it This study is concerned with an evaluation of the effects of glucocorticoids (GC) on adiponectin and leptin concentra- tions in patients with polymyalgia rheumatica (PMR). Seven patients diagnosed with PMR were studied at baseline and after one and three months of prednisone treatment. Serum leptin and adiponectin, serum glucose and insulin, erythrocyte sedimentation rate, C-reactive protein, and IL-6 were all measured by commercial assays. The treatment with GC normalized inflammation markers and significantly increased adiponectin and leptin concentrations with- out any impairment of insulin sensitivity measured by HOMA-IR. Adiponectin significantly increased only between baseline and 1 month (P = 0.013). A significant correlation was found between adiponectin and leptin concentrations both at baseline and after 3 months of treatment (both rho = 0.89, P = 0.03). In addition, adiponectin correlated also with serum glucose at baseline (rho = 0.81, P = 0.047). According to our results, adiponectin concentrations seem to be driven by inflammation, whereas leptin seems to be increased directly by the use of steroids. Keywords: adiponectin; leptin; adipocytokines; polymyalgia rheumatica; inflammation Introduction Adiponectin is a hormone produced by adipocytes with important effects on metabolism and the car- diovascular system, which reaches high plasma con- centrations 1 and circulates in multimeric isoforms. Adiponectin has antiatherogenic and insulin- sensitizing effects and its levels are reduced in pa- tients with obesity, insulin resistance, and cardio- vascular disease. 2 These conditions share low-grade inflammation. Several clinical studies have demon- strated an inverse relationship between plasma adiponectin levels and a number of inflammatory markers, including C-reactive protein. 3 As an ex- ample, there is a bidirectional relation between adiponectin and tumor necrosis factor-alpha (TNF- ): TNF- suppresses adiponectin production in vitro 4 while adiponectin antagonizes many effects of TNF-. In contrast with these findings, increased local and/or systemic adiponectin levels have been described in autoimmune, chronic, inflammatory diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel diseases. 5,6 Leptin, the product of the ob gene, decreases food intake and increases energy expenditure. Its role in regulating the immune and inflammatory responses has been recently reviewed. 7 Leptin concentrations increase during inflammation and infection, sug- gesting that it could act as a cytokine per se and addi- tionally stimulate the production of other cytokines. The behavior of the two adypocytokines in inflam- matory joint diseases is controversial: inflamma- tion should decrease adiponectin concentrations 8 but in rheumatoid arthritis (RA), a chronic inflam- matory condition, both leptin and adiponectin are usually increased. 5 More information on the rela- tionship between inflammation and adipocytokines doi: 10.1111/j.1749-6632.2009.05364.x 160 Ann. N.Y. Acad. Sci. 1193 (2010) 160–163 c  2010 New York Academy of Sciences.