THE RELATIONSHIP BETWEEN ADIPOKINES AND THE THICKNESS OF SUBCUTANEOUS ADIPOSE TISSUE IN LIPEDEMA

Year 2022, Volume: 9 Issue: 2, 296 - 304, 30.06.2022

Zeliha Ünlü Tuğba Çavuşoğlu Funda Kosova Ali Aydın

https://doi.org/10.34087/cbusbed.1062223

Abstract

Objective: Attention has been drawn to the role of visceral adipose tissue changes rather than subcutaneous adipose tissue the relationship between adipokines and dysfunctional adipose tissue. Especially in lipedema in which subcutaneous adipose tissue is affected, the information on adipokines is insufficient. In this study, it aimed to investigate the levels of adiponectin, ghrelin, resistin and visfatin and their relationship with adipose tissue thickness in patients with lipedema. For this purpose, the thickness of the subcutaneous adipose tissue was objectively evaluated by ultrasound.
Materials and Methods: A total of 19 female patients diagnosed with lipedema and 15 healthy women with no age difference were included in the study. The thickness of the skin and subcutaneous adipose tissue was measured by ultrasound. The serum levels of adiponectin, ghrein, resistin and visfatin of all subjects were measured using the sandwich ELISA protocol.
Results: In patients with lipedema, the thickness subcutaneous tissue and thickness of total skin-subcutaneous were significantly increased at skin the thigh and calf, excluding skin thickness in the thigh, compared to controls (P<0.000). There was no significant difference in serum levels of adiponectin, ghrelin, resistin and visfatin between patients with lipedema and controls (P>0.05). No significant correlation was found between adiponectin, ghrelin, resistin and visfatin and subcutaneous and total thickness measurements by ultrasound in patients with lipedema and controls (P>0.05). Although not statistically significant, when examined as positive or negative correlations were observed between the groups in the relationship between adipokines and ultrasound.
Conclusion: According to our findings, although no significant relationship was found between serum levels of adipokines and subcutaneous adipose tissue thickness, it is controversial that they are completely unrelated. Further studies in larger series will shed light on the relationship between adipokines and subcutaneous tissue thickness and the importance of ultrasonography.

Keywords

Adiponectin, Lipodemea, Resistin

Supporting Institution

BAP

Project Number

2020-106

LİPÖDEMDE SUBKÜTAN YAĞ DOKUSU KALINLIĞI İLE ADİPOKİNLER ARASINDAKİ İLİŞKİ

Abstract

Giriş ve Amaç: Adipokinler ve disfonksiyonel yağ dokusu arasındaki ilişkide subkutan yağ dokusundan ziyade viseral yağ dokusundaki değişikliklerin rolüne dikkat çekilmiştir. Özellikle cilt altı yağ dokusunun etkilendiği lipödemde adipokinler hakkında bilgi yetersizdir. Bu çalışmada lipödemli hastalarda adiponektin, ghrelin, resistin ve visfatin düzeylerinin ve bunların yağ doku kalınlığı ile ilişkisinin araştırılması amaçlandı. Bu amaçla cilt altı yağ dokusu kalınlığı ultrasonografi ile objektif olarak değerlendirildi.
Gereç ve Yöntemler: Lipödem tanısı almış toplam 19 kadın hasta ve yaş farkı olmayan 15 sağlıklı kadın çalışmaya dahil edildi. Deri ve deri altı yağ dokusu kalınlıkları ultrasonografik olarak ölçüldü. Tüm deneklerin serum adiponektin, ghrein, resistin ve visfatin seviyeleri sandviç ELISA protokolü kullanılarak ölçüldü.
Bulgular: Lipödemli hastalarda, uyluk ve baldırda subkutan subkutan doku kalınlığı ve toplam deri-subkutan kalınlığı kontrollere kıyasla, uyluktaki deri kalınlığı dışında önemli ölçüde arttı (P<0.000). Lipödemli hastalar ve kontroller arasında adiponektin, ghrelin, resistin ve visfatin serum seviyelerinde anlamlı fark yoktu (P>0.05). Lipödemli hastalarda ve kontrollerde ultrason ile adiponektin, ghrelin, resistin ve visfatin ile deri, deri altı ve toplam kalınlık ölçümleri arasında anlamlı bir ilişki bulunmadı (P>0.05). İstatistiksel olarak anlamlı olmasa da detaylı incelendiğinde adipokinler ve ultrason ölçümleri arasındaki ilişkide gruplar arasında pozitif veya negatif korelasyonlar gözlendi.
Sonuç: Bulgularımıza göre, serum adipokin düzeyleri ile deri altı yağ dokusu kalınlığı arasında anlamlı bir ilişki bulunmamakla birlikte, tamamen ilgisiz oldukları tartışmalıdır. Daha geniş serilerde yapılacak çalışmalar adipokinlerin cilt altı doku kalınlığı ile ilişkisine ve ultrasonografinin önemine ışık tutacaktır.

Keywords

Lipödem, Adipokin, Resistin

Project Number

2020-106

References

• 1. Lancha A, Frühbeck G, Gómez-Ambrosi J. Peripheral signalling involved in energy homeostasis control. Nutrition Research Reviews, 2012; 25(2): 223–48.
• 2. Unamuno X, Gómez-Ambrosi J, Rodríguez A, Becerril S, Frühbeck G, Catalán V. Adipokine dysregulation and adipose tissue inflammation in human obesity. European Journal of Clinical Investigation, 2018; 48(9): e12997.
• 3. ´ Omez-Ambrosi JG, Cataí V, Rodríguez A, Andrada P, Ramírez B, Ibá~ P, et al. Increased Cardiometabolic Risk Factors and Inf lammation in Adipose Tissue in Obese Subjects Classified as Metabolically Healthy. 2014; http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc14-0937/-/DC1.
• 4. Frühbeck G, Catalán V, Rodríguez A, Ramírez B, Becerril S, Portincasa P, et al. Normalization of adiponectin concentrations by leptin replacement in ob/ob mice is accompanied by reductions in systemic oxidative stress and inflammation. Scientific Reports, 2017; 7(1): 1–12.
• 5. Sethi JK, Vidal-Puig A. Visfatin: the missing link between intra-abdominal obesity and diabetes? Trends in Molecular Medicine, 2005; 11(8): 344.
• 6. Giorgino F, Laviola L, Eriksson JW. Regional differences of insulin action in adipose tissue: insights from in vivo and in vitro studies. Acta Physiologica Scandinavia, 2005; 183(1): 13–30.
• 7. Castro A, Kolka C, Kim S, Bergman R. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arquivos Brasileiros de Endocrinologia e Metabologia, 2014; 58(6): 600–9.
• 8. Crescenzi R, Marton A, Donahue P, Mahany H, Lants S, Wang P, et al. Tissue Sodium Content is Elevated in the Skin and Subcutaneous Adipose Tissue in Women with Lipedema. Obesity 2018; 26(2): 310–7.
• 9. Wold L, EA H, EV A. Lipedema of the legs; a syndrome characterized by fat legs and edema. Annals of Internal Medicine, 1951; 34(5): 1243–50.
• 10. Halk A, Damstra R. First Dutch guidelines on lipedema using the international classification of functioning, disability and health, Phlebology, 2017; 32(3): 152–9.
• 11. Buso G, Depairon M, Tomson D, Raffoul W, Vettor R, Mazzolai L. Lipedema: A Call to Action! Obesity, 2019; 27(10): 1567–76.
• 12. Naouri M, Samimi M, Atlan M, Perrodeau E, Vallin C, Zakine G, et al. High-resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema. British Journal of Dermatology, 2010; 163(2): 296–301.
• 13. Marshall M, Schwahn-Schreiber ; C. Prävalenz des Lipödems bei berufs-tätigen Frauen in Deutschland (Lipödem-3-Studie). 2011; Available from: www.phlebologieonline.de
• 14. Reich-Schupke S, Altmeyer P, Stücker M. Thick legs - not always lipedema. J Dtsch Dermatol Ges 2013; 11(3): 225–33.
• 15. Suehiro K, Morikage N, Murakami M, Yamashita O, Ueda K, Samura M, et al. Subcutaneous tissue ultrasonography in legs with dependent edema and secondary lymphedema. Annals of Vascular Diseases, 2014; 7(1): 21–7.
• 16. Suehiro K, Morikage N, Murakami M, Yamashita O, Samura M, Hamano K. Significance of ultrasound examination of skin and subcutaneous tissue in secondary lower extremity lymphedema. Annals of Vascular Diseases, 2013; 6(2): 180–8.
• 17. Suehiro K, Morikage N, Ueda K, Samura M, Takeuchi Y, Nagase T, et al. Aggressive Decongestion in Limbs with Lymphedema without Subcutaneous Echo-Free Space. Annals of Vascular Surgery,2018; 53: 205–11.
• 18. Casley-Smith J. Measuring and representing peripheral oedema and its alterations. Lymphology, 1994; 27(2): 56–70.
• 19. Iker E, Mayfield CK, Gould DJ, Patel KM. Characterizing lower extremity lymphedema and lipedema with cutaneous ultrasonography and an objective computer-assisted measurement of dermal echogenicity. Lymphatic Research and Biology, 2019; 17(5): 525–30.
• 20. Staub C, Venturi E, Cirot M, Léonard L, Barrière P, Blard P, et al. Ultrasonographic measures of body fatness and their relationship with plasma levels and adipose tissue expression of four adipokines in Welsh pony mares. Domestic Animal Endocrinology, 2019; 69: 75–83.
• 21. Störchle P, Müller W, Sengeis M, Lackner S, Holasek S, Fürhapter-Rieger A. Measurement of mean subcutaneous fat thickness: eight standardised ultrasound sites compared to 216 randomly selected sites. Scientific Reports, 2018; 8(1): 1–12.