الفهرس 
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Abstract
Rheumatoid arthritis (RA) patients have a greater risk of fragility fracture than others normal people. In addition to traditional risk factors of physical disability, inadequate treatment, and disease activity, patients are at high risk of bone loss and osteoporosis.
Several promising biomarkers were suggested in order to identify incidence of osteoporosis among RA patients including serum adiponectin.
Adiponectin is well known for its different effect on skeletal system. This encouraged us to identify the value of adiponectin among RA patients, in addition to evaluating serum adiponectin as a potential predictor of OP among RA female patients.
The study included 30 premenopausal RA female patients aged ranged from 26 to 46 years old with a mean of (37.2 ± 6.9) and BMI ranged from 23 to 37.34 with a mean (29.85 ± 4.06) compared to 15 age matched healthy controls ,they were subjected to full history taking, laboratory investigation was done to exclude other causes of osteoporosis. Serum level of adiponectin was measured by ELISA using kites. They were also assessed radiologically by DEXA scan of lumbar spine to confirm OP.
In our study we found that RA patients had statistically significant higher adiponectin level than healthy controls (1574± 565.4 vs 345± 153.6 μg/L, p<0.001). Moreover, serum adiponectin was significantly higher in patients with both RA and OP (1993± 489.6 μg/L) compared to RA female patients only (1155± 215.3 μg/L) (p<0.001).
Moreover, , our results demonstrated that a serum adiponectin of 1400 μg/L or higher is capable of detecting osteoporosis among RA patients with a sensitivity of 100% and a specificity of 100%. Regarding predictive ability of adiponectin in detecting RA with osteoporosis, our findings showed that there was an inverse association between adiponectin level and bone density, and there was a significant negative correlation between adiponectin level and DEXA scores in RA group (r = -0.635) (p=0.011) and RA with OP group (r = -0.606) (p=0.017).
So, this study confirms that adiponectin with its pro infilammatory properties plays an important role in the pathogenesis of both RA and OP thus, inhibition of adiponectin multimers may provide a tool for developing therapeutic approaches in RA therapy.
However, further studies with larger sample size is highly required to obtain high level of evidence regarding routine use of adiponectin in RA patients to confirm prediction of osteoporosis in order to apply all proper management steps to this type of patients.