Obesity in Autoimmune Diseases: Not a Passive Bystander

Mathilde Versini*, Pierre Yves Jeandel, Eric Rosenthal, Yehuda Shoenfeld

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


In the last decades, autoimmune diseases have experienced a dramatic increase in Western countries. The involvement of environmental factors is strongly suspected to explain this rise. Particularly, over the same period, obesity has followed the same outbreak. Since the exciting discovery of the secretory properties of adipose tissue, the relationship between obesity and autoimmunity and the understanding of the underlying mechanisms have become of major interest. Indeed, the fat tissue has been found to produce a wide variety of "adipokines," involved in the regulation of numerous physiological functions, including the immune response. By conducting a systematic literature review, we extracted 329 articles regarding clinical, experimental, and pathophysiological data on the relationship between obesity, adipokines-namely leptin, adiponectin, resistin, visfatin-and various immune-mediated conditions, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), multiple sclerosis (MS), type 1 diabetes (T1D), psoriasis and psoriatic arthritis (PsA), and thyroid autoimmunity (TAI), especially Hashimoto thyroiditis. The strongest levels of evidence support an increased risk of RA (OR. =. 1.2-3.4), MS (OR. =. 2), psoriasis, and PsA (OR. =. 1.48-6.46) in obese subjects. A higher risk of IBD, T1D, and TAI is also suggested. Moreover, obesity worsens the course of RA, SLE, IBD, psoriasis, and PsA and impairs the treatment response of RA, IBD, psoriasis, and PsA. Extensive clinical data and experimental models demonstrate the involvement of adipokines in the pathogenesis of these autoimmune diseases. Obesity appears to be a major environmental factor contributing to the onset and progression of autoimmune diseases.

Original languageEnglish
Title of host publicationMosaic of Autoimmunity
Subtitle of host publicationThe Novel Factors of Autoimmune Diseases
Number of pages30
ISBN (Electronic)9780128143087
ISBN (Print)9780128143070
StatePublished - 13 Feb 2019


  • Adipokines
  • Autoimmune diseases
  • Autoimmunity
  • Obesity
  • Overweight
  • White adipose tissue


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