Adipokines as predictors of recovery from upper extremity soft tissue disorders

Abstract

Objectives. To study the associations of adipokines with recovery from upper extremity soft tissue disorders (UESTDs) and to explore whether overweight or obesity modify these associations. Methods. In this follow-up study, patients seeking medical advice due to incipient upper extremity symptoms with symptom duration <1 month were included (n = 163). The outcome of the study was full or substantial recovery from UESTDs, assessed at 2, 8 and 12 weeks of follow-up. We studied the associations of four adipokines (leptin, adiponectin, resistin and visfatin) with recovery using the generalized estimating equation. Results. Of the study population, 27.5% reported full or substantial recovery at the 8-week follow-up and 32% at 12 weeks. Higher levels of resistin [odds ratio (OR) = 1.58, 95% CI 1.18, 2.11 for 1 S.D. increase] and visfatin (OR = 1.29, 95% CI 0.94, 1.78 for 1 S.D. increase) at baseline predicted a higher recovery rate at the 8-week follow-up. Moreover, higher levels of leptin predicted a lower rate of recovery (OR = 0.73, 95% CI 0.51, 1.02 for 1 S.D. increase). Adipokines did not predict recovery at 12 weeks. In subgroup analyses, high levels of resistin and visfatin at baseline predicted a higher recovery rate during follow-up in non-overweight patients. Conclusion. The adipokines resistin and visfatin predicted recovery from UESTDs and the associations may be related to stimulation of anti-inflammatory response mechanisms. A higher level of leptin may prevent recovery from UESTDs.