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To the Editor: In their Research Letter, Dr Schäffler and colleagues¹ found adiponectin and resistin in the synovial fluid of patients with rheumatoid arthritis (RA) and, to a lesser degree, in those with osteoarthritis (OA). The authors suggested that these 2 adipocytokines might play a role in chronic inflammatory joint disease. They also found a positive association between adiponectin and C-reactive protein (CRP) in patients with OA, which is at variance with the previously reported inverse correlation between plasma adiponectin and markers of inflammation such as CRP, tumor necrosis factor (TNF-), and interleukin 6.^2-3 Other studies have suggested that adiponectin has an anti-inflammatory rather than a proinflammatory effect.⁴

The findings of Schäffler et al may be due to the use of glucocorticoids in their patients with RA, rather than to the disease itself. Glucorticoids can be expected to suppress TNF-, a potent negative modulator of adiponectin.⁵ The higher . . . [Full Text of this Article]

Norbert Stefan, MD
norbert.stefan@med.uni-tuebingen.de

Hans-Ulrich Häring, MD; Michael Stumvoll, MD
Department of Internal Medicine
University of Tübingen
Tübingen, Germany

RELATED LETTER

Adipocytokines in Synovial Fluid
Andreas Schäffler, Angela Ehling, Elena Neumann, Hans Herfarth, Ingo Tarner, Jürgen Schölmerich, Ulf Müller-Ladner, and Steffen Gay
JAMA. 2003;290(13):1709-1710.
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Regulation of Synovial Adipocytokines—Reply
Andreas Schäffler and Ulf Müller-Ladner
JAMA. 2004;291(6):695.
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