Smoking Functions as a Negative Regulator of IGF1 and Impairs Adipokine Network in Patients with Rheumatoid Arthritis

Figure 3

Graphic summary. The combined results obtained on patients with early RA (the Leiden cohort, ) and on patients with established and treated RA (the Gothenburg cohort, ) indicate that cigarette smoking may be a major cause of acquired IGF1 and leptin deficiency in RA. The multivariate analysis confirmed an association between smoking, IGF1, and leptin, where hypoleptinemia was also shown to be a consequence of higher disease activity. These novel associations are of potential importance for long-term prognosis and in risk assessment for complications and comorbidities in RA.