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Studies on trabecular bone score (TBS) in psoriasis are lacking. We aim to assess the association between TBS and inflammation, metabolic syndrome features, and serum adipokines in 29 nondiabetic patients with psoriasis without arthritis, before and after 6-month adalimumab therapy. For that purpose, adjusted partial correlations and stepwise multivariable linear regression analysis were performed. No correlation was found between TBS and disease severity. TBS was negatively associated with weight, BMI, waist perimeter, fat percentage, and systolic and diastolic blood pressure before and after adalimumab. After 6 months of therapy, a negative correlation between TBS and insulin resistance (p=0.02) and leptin (p=0.01) and a positive correlation with adiponectin were found (p=0.01). The best set of predictors for TBS values at baseline were female sex (p=0.015), age (p=0.05), and BMI (p=0.001). The best set of predictors for TBS following 6 months of biologic therapy were age (p=0.001), BMI (p<0.0001), and serum adiponectin levels (p=0.027). In conclusion, in nondiabetic patients with moderate-to-severe psoriasis, TBS correlates with metabolic syndrome features and inflammation. This association is still present after 6 months of adalimumab therapy. Moreover, serum adiponectin levels seem to be an independent variable related to TBS values, after adalimumab therapy.

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) disease. AS patients also display a high prevalence of features clustered under the name of metabolic syndrome (MeS). Anti-TNF- α therapy was found to be effective to treat AS patients by suppressing inflammation and also improving endothelial function. Previously, it was demonstrated that a short infusion of anti-TNF- α monoclonal antibodyinfliximab induced a rapid and dramatic reduction in serum insulin levels and insulin resistance along with a rapid improvement of insulin sensitivity in nondiabetic AS patients. The role of adipokines, MeS-related biomarkers and biomarkers of endothelial cell activation and inflammation seem to be relevant in different chronic inflammatory diseases. However, its implication in AS has not been fully established. Therefore, in this review we summarize the recent advances in the study of the involvement of these molecules in CV disease or MeS in AS. The assessment of adipokines and biomarkers of endothelial cell activation and MeS may be of potential relevance in the stratification of the CV risk of patients with AS. Acknowledgments. The authors thank Mrs. Susana Escandon and Isabel Castro Fernandez, nurses from the Rheumatology Outpatient Clinic, Ms. Pilar Ruiz, a nurse from the Hematology Division, and the members of the Biochemistry Department from Hospital Lucus Augusti/Xeral-Calde, Lugo, for their valuable help to undertake this study. This study was supported by the European Union FEDER funds and “Fondo de Investigación Sanitaria” (Grants PI06/0024, PS09/00748, and PI12/00060) (Spain). This work was also partially supported by RETICS Programs, RD08/0075 (RIER) and RD12/0009/0013, from “Instituto de Salud Carlos III” (ISCIII) (Spain). Fernanda Genre and Begona Ubilla are supported by funds from the ˜RETICS Program (RIER). Raquel Lopez Mejías is a recipient of a Sara Borrell postdoctoral fellowship from the Instituto de Salud Carlos III at the Spanish Ministry of Health (Spain).

Like rheumatoid arthritis, ankylosing spondylitis (AS) is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS) features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1) is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-α antagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA), an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r = -0.397; P = 0.04). However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-α therapy, IGF-1 and ADMA are inversely correlated. Acknowledgments The authors thank Mrs. Susana Escandon and Isabel Castro Fernandez, nurses from the Rheumatology Outpatient Clinic, Ms. Pilar Ruiz, a nurse from the Hematology Division, and the members of the Biochemistry Department from Hospital Lucus Augusti/Xeral-Calde, Lugo, for their valuable help to undertake this study. This study was supported by the European Union FEDER funds and “Fondo de Investigación Sanitaria” (Grants PI06/0024, PS09/00748, and PI12/00060) (Spain). This work was also partially supported by RETICS Programs, RD08/0075 (RIER) and RD12/0009/0013, from “Instituto de Salud Carlos III” (ISCIII) (Spain). Fernanda Genre and Begona Ubilla are supported by funds from the ˜RETICS Program (RIER). Raquel López Mejías is a recipient of a Sara Borrell postdoctoral fellowship from the Instituto de Salud Carlos III at the Spanish Ministry of Health (Spain).