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Ali AY, Abdullah H, Abdallah MFH, Fayed A. Impact of Adipokines in Brachial Artery Flow-mediated Dilatation in Lupus Nephritis. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2022; 33:272-279. [PMID: 37417179 DOI: 10.4103/1319-2442.379025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Endothelial dysfunction is evident in systemic lupus erythematosus (SLE). Pro-inflammatory adipokines are involved in endothelial derangement and premature atherosclerosis, particularly in lupus nephritis (LN). This study aimed to investigate the impact of LN on endothelial function by estimating the serum levels of adiponectin, leptin, visfatin, and homeostatic model assessment-insulin resistance (HOMA-IR) and calculating the flow-mediated dilatation (FMD) of the brachial artery. This is a case-control study in which 190 systemic lupus patients who were fulfilling the American College of Rheumatology revised classification were enrolled. The patients were divided into 100 LN patients and 90 lupus non-nephritis patients. Demographic data, clinical parameters, and SLE activity were reported. Serum adiponectin, leptin, visfatin, and HOMA-IR were measured. The endothelial dysfunction was assessed by calculating the FMD of the brachial artery. The mean age of participants was 25.62 ± 5.81 years. Elevated levels of adiponectin, leptin, visfatin, and HOMA-IR were observed in LN cases (12.2 ± 0.3, 20.1 ± 0.5, 16.8 ± 0.1, and 12.0 ± 3.8, respectively) compared to non-nephritis cases (12.2 ± 0.3, 8.5 ± 0.5, 16.8 ± 0.5, and 9.0 ± 3.8, respectively) with a more reduced FMD percentage in LN cases with a statistical significance. Brachial artery FMD is negatively correlated with lipid profile, adipokines, and HOMA. Visfatin has better sensitivity (82.1%) and specificity (81%) with the area under a curve of 0.893, compared to other biomarkers. LN patients are characterized by impaired endothelial function. Elevated serum adiponectin, visfatin, and HOMA-IR were significantly correlated with poor FMD of the brachial artery. Visfatin has a better performance in detecting atherosclerosis.
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Affiliation(s)
- Ahmed Y Ali
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hend Abdullah
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Ahmed Fayed
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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Chougule D, Nadkar M, Venkataraman K, Rajadhyaksha A, Hase N, Jamale T, Kini S, Khadilkar P, Anand V, Madkaikar M, Pradhan V. Adipokine interactions promote the pathogenesis of systemic lupus erythematosus. Cytokine 2018; 111:20-27. [PMID: 30098476 DOI: 10.1016/j.cyto.2018.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Adipokines are chemical mediators released from adipose tissue involved in regulation of appetite, insulin sensitivity, immune system and inflammatory responses. Adipokines contributes to low grade inflammatory response in autoimmune disease like Systemic Lupus Erythematosus (SLE) but the pathophysiology is yet not clear. The aim of this study is to understand role of adipokine interactions in SLE disease pathogenesis. METHODS Sixty newly diagnosed treatment naïve SLE patients fulfilling the ACR criteria and forty age-sex matched healthy subjects were enrolled in thiscase-control study. Disease activity in SLE patients was evaluated using SELENA-SLEDAI. Array of adipokines, C1q circulating immune complexes (C1q-CIC), anti-C1q, anti-ribososmal P0 (anti-RibP0) and anti-mitochondrial antibodies (AMA) levels were detected by ELISA. Antinuclear antibodies (ANA) and anti-dsDNA autoantibodieswere detected by Indirect Immunofluorescence (IIF), while antigen specificities were detected by Immunoassay blot. Serum levels of C3 and C4 complement factors were assessed by nephlometer. RESULTS Statistically significant elevation in progranulin, adipsin and resistin levels was seen among SLE patients when compared to healthy controls (p < 0.0001). Leptin and omentin levels were significantly reduced in SLE patients (p < 0.0001). There was no statistically significant difference in serum adiponectin, chemerin and visfatin levels when these two groups were compared (p > 0.05). Adiponectin, adipsin and resistin levels were elevated in SLE patients with renal manifestations (p < 0.05). Reduced leptin levels were significantly associated with presence of renal manifestations (p < 0.05). Adiponectin levels positively correlated with disease activity (r = 0.294, p = 0.027) whereas negatively correlated with C3 levels (r = -0.439, p = 0.0007). A positive correlation was observed between hypocomplementemia and leptin levels (p < 0.05). Leptin levels were negatively correlated with disease activity, anti-dsDNA, C1q-CIC and anti-C1q levels (p < 0.05). A significant positive correlation was observed between progranulin levels and anti-ribosomal P0 antibodies (r = 0.499, p < 0.0001). CONCLUSION Adipokines levels and associated clinical manifestations suggest involvement of adipokines in disease pathogenesis of SLE. SLE disease activity and complement components may suggest regulatory effect of adipokines (adiponectin and leptin) on disease pathogenesis. Further studies on adipokines in SLE patients with renal manifestations may propose them as prognostic markers in renal damage. TRIAL REGISTRATION NA.
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Affiliation(s)
- Durga Chougule
- Department of Clinical & Experimental Immunology, National Institute of Immunohaematology (Indian Council of Medical Research), 13th Floor, KEM Hospital Campus, Parel, Mumbai, India
| | - Milind Nadkar
- Department of Medicine, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
| | | | - Anjali Rajadhyaksha
- Department of Medicine, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India.
| | - Niwrutti Hase
- Department of Nephrology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
| | - Tukaram Jamale
- Department of Nephrology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
| | - Seema Kini
- Department of Medicine, TNMC & BYLN, Mumbai, India
| | - Prasad Khadilkar
- Department of Clinical & Experimental Immunology, National Institute of Immunohaematology (Indian Council of Medical Research), 13th Floor, KEM Hospital Campus, Parel, Mumbai, India
| | - Vidya Anand
- Chennai Meenakshi Multi-speciality Hospital, Chennai, India
| | - Manisha Madkaikar
- Department of Clinical & Experimental Immunology, National Institute of Immunohaematology (Indian Council of Medical Research), 13th Floor, KEM Hospital Campus, Parel, Mumbai, India
| | - Vandana Pradhan
- Department of Clinical & Experimental Immunology, National Institute of Immunohaematology (Indian Council of Medical Research), 13th Floor, KEM Hospital Campus, Parel, Mumbai, India.
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Abou Ghanima AT, Almaghraby MF, Elsaadany HM, Hosny MA, Kumar RK. Urinary podocalyxin and nephrin levels as biomarkers in lupus nephritis patients: Relation to renal involvement and disease activity. THE EGYPTIAN RHEUMATOLOGIST 2016. [DOI: 10.1016/j.ejr.2015.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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