Body fat has regulatory functions through producing cytokines and adipokines whose role in the pathogenesis of Systemic Sclerosis (SSc) is currently emerging. Changes in body mass, either overweight or underweight status, entail a dysregulation of the cytokines/adipokines network that may impact on SSc disease activity. We evaluated serum levels of adipokines and cytokines in SSc patients and correlated them to clinical features and body mass index (BMI) categories.

The study included 89 SSc patients and 26 healthy donors (HD). Serum levels of adiponectin, leptin, resistin, visfatin, TNFα, IFNγ, IL-2, IL-10, and IL-17A were measured by Multiplex Immunoassay, and correlated to BMI, and disease specific features. t-Student test or ANOVA, were used for comparisons between groups. Spearman’s or Pearson’s test were used for correlation analysis.

Serum levels of TNFα, IL-2, leptin, and resistin, were significantly higher in SSc than in HD. Leptin levels were significantly higher in ILD- and PAH- SSc subgroups. The highest levels of IL-17A, IL-2, IL-10, leptin and visfatin were detected in SSc patients with obesity (p <0.01). Conversely, underweight SSc patients showed the highest TNFα levels (p<0.05).

Adipokines, IL-2, IL-10 and IL-17A were found to be increased in SSc patients with obesity, but whether they play a role in the pathogenesis of the disease remains to be investigated. Intriguingly, underweight patients had highest TNFα levels, suggesting a potential role of TNFα in inducing the cachexia observed in long-lasting disease.