Adipokines, Biomarkers of Endothelial Activation, and Metabolic Syndrome in Patients with Ankylosing Spondylitis

Figure 1

Pathophysiologic context that encompasses all the molecules reviewed in this paper. Ankylosing spondylitis patients display a high incidence of features clustered under the name of metabolic syndrome, which include obesity, dyslipidemia, hypertension, alterations in glucose metabolism, including insulin resistance, and also a dysregulation of adipokines. Moreover, all these pathologic features are associated with inflammation and lead to endothelial dysfunction and, consequently, to an enhanced risk of CV disease (mainly due to accelerated atherosclerosis) and CV death in these patients. Anti-TNF-α treatment not only suppresses inflammation, reducing thus ankylosing spondylitis activity, but it also improves endothelial function in these patients. The molecules that will be reviewed in this paper are included in this figure inside blue dashed boxes. *Anti-TNF-α improves insulin resistance and endothelial function and also reduces inflammation. ADMA: asymmetric dimethylarginine; Angpt-2: angiopoietin-2; OPG: osteoprotegerin; OPN: osteopontin; RBP-4: retinol binding protein-4.