Ankilozan Spondilitli Hastalarda Leptin Seviyesi ve Hastalık Aktivitesi ile İlişkisi

Abstract

Keywords

• -

Ankilozan Spondilitli Hastalarda Leptin Seviyesi ve Hastalık Aktivitesi ile İlişkisi

Abstract

Amaç: Ankilozan spondilit (AS)'li hastalarda serum leptin seviyeleri ile hastalık aktivite göstergeleri olan Bath AS Hastalık Aktivite indeksi (BASDAI), Eritrosit sedimentasyon hızı (ESH), C-reaktif protein (CRP) düzeyleri arasındaki ilişkinin saptanması. Gereç: 23'ü erkek, 7'si kadın 30 AS'li hasta çalışm aya alındı. Kontrol grubu hastalarla benzer yaş, cinsiyet, beden kitle indeksi (BMI) özelliklerine sahip 16'sı erkek, 5'i kadın, 21 sağlıklı kişiden oluşturuldu. Hastalığı modifiye edici antiromatizmal ilaç (DMARD) tedavisi alan 9'u erkek, 3'ü kadın 12 has ta ve DMARD tedavisi almayan 14'ü erkek, 4'ü kadın 18 hastada, leptin düzeylerinin hastalık aktivitesinin klinik ve laboratuar göstergeleri ile olan ilişkisi araştırıldı. Klinik aktivite göstergesi olarak BASDAI hesaplandı ve laboratuar aktivite göstergesi olarak ESH ve CRP değerleri ölçüldü. Bulgular: Hastaların leptin değerleri kontrol grubundan anlamlı yüksekti. Bu yükseklik DMARD tedavisi almayan grupta daha belirgindi. Leptin düzeylerindeki yükseklik BASDAI, ESH ve CRP seviyeleri ile pozitif korelasyon gösterdi. Sonuç: AS'li hastalarda leptin seviyeleri kontrol grubuna göre daha yüksek bulunmuştur. Bu fark DMARD tedavisi almayan hasta grubunda daha belirgindir Hastalardaki yüksek leptin seviyeleri hastalığın klinik ve laboratuvar aktivite kriterleri ile pozitif korelasyon göstermektedir

Keywords

• Ankilozan spondilit, leptin, hastalık aktivitesi

References

1. Van der Linden S, Van der Heijde D: Ankylosing spondylitis. Ruddy S, Harris DH, Sledge C (Ed): Kelley's A Textbook of Rheumatology. WB Saunders Company, Philadelphia 2001;p: 1039-53.
2. Allen RL, Bowness P, McMichael A: The role of HLA-B27 in spondylarthritis. Immunogenetics 1999;50:220-7.
3. Mc Michael A, Bowness P. HLA-B27: natural function and pathogenic role in spondylarthritis. Arthritis Res. 2002; 4 Suppl 3:S 153-8.
4. Zhang Y, Proenca R, Maffei M, Leopold L, Friedman JM. Positional cloning of the mause obese gene and human homologue. Nature, 1994;372:425-32.
5. Pelleymounter MA et all.Effects of the obese gene product on body weight regulation in ob/ob mice. Science 1995;269:540-3.
6. Palmer G, Gabay C. A role for leptin in rheumatic diseases? Ann Rheum Dis.2003;62:913-15.
7. Yegen B. infeksiyon ve inflamasyonda leptin. Genel Tip Dergisi 2003; 13(2,Ek) 13-8.
8. Aslan K, Serdar Z, Tokullugil AH: Multifonksiyonel Hormon: Leptin. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2004;30:113-8.

9. Lord GM, Matarese G, Howard JK et al: Leptin modulates the T-cell immun response and reverses starvation-induced immunosuppression. Nature 1998:394;897-901.
10. Anders HJ, Rihl M, Heufelder A, Loch O, Schattenkirchner M. Leptin serum levels are not correlated with disease activity in patients with rheumatoid arthritis. Metabolism. 1999;;48(6):745-8.
11. Tokarczyk-Knapik A, Nowicki M, Wyroslak J. The relation between plasma leptin concentration and fat mass in patients with rheumatoid artritis. Pol Arch Med Wewn.2002;; 108(2):761-7.
12. Nishiya K, Nishiyama M, Chang A, Shinto A, Hashimoto K. Serum leptin levels in patients with rheumatoid arthritis are correlated with body mass index. Rinsho Byori. 2002;;50(5):524-7.
13. Bokarewa M, Bokarew D, Hultgren O, Tarkowski A. Leptin consumption in the inflamed joints of patients with rheumatoid artritis. Ann Rheum Dis 2003;62:952-6.
14. Perfetto F, Tarquini R, Simonini Get al. Circulating leptin levels in juvenile idiopathic arthritis: a marker of nutritional status? Ann Rheum Dis 2005;64:149-52.
15. Popa C, Netea MG, Radstake TR, et al. Markers of inflammation are negatively correlated with serum leptin in rheumatoid arthritis. Ann Rheum Dis. 2005;64(8):1195-8
16. Weyand CM: new insights into the pathogenesis of rheumatoid arthritis: Rheumatology (Oxford).2000;39 suppl 1:3-8
17. Garcia-Gonzalez A, Gonzalez-Lopez L, Valera-Gonzalez IC, et al. Serum leptin levels in women with systemic lupus erythematosus.Rheumatol Int 2002;22:138-41.
18. Evereklioglu C, Inaloz HS, Kirtak N, et al. Serum leptin concentration is increased in patients with Behcet syndrome and is correlated with disease activity.BR J Dermatol. 2002.; 147(2):331-6.
19. Van der Linden S. Ankylosing spondylitis. In: Kelley N, Ruddy S, Haris E, Sledge C (Ed). Textbook of Rheumatology. WB Saunders Company, Philadelphia. 1997; 969-82
20. Gratacos J, Collado A, Filella X, et al. Serum cytokines (IL-6, TNFalpha,IL-1 beta and IFN-gamma) in ankylosing spondylitis: a close correlation between serum IL-6 and disease activity and severity. Br J Rheumatol 1994; 33: 927-31.
21. Park M, Lee S, Choi S, et al. Serum leptin levels correlate with interleukin-6 levels and disease activity in patients with ankylosing spondylitis. Scand J Rheumatol 2007; 36: 101-6.
22. Sari I, Demir T, Kozaci LD, et al. Body composition, insulin, and leptin levels in patients with ankylosing spondylitis. Clin Rheumatol 2007; 9:1427-32.
23. Park M, Chung S . Pro-inflammatory effect of leptin on peripheral blood mononuclear cells of patients with ankylosing spondylitis. Joint Bone Spine 2009; 2: 170-5.
24. Amor B, Dougados M, Khan MA. Management of refractory ankylosing spondylitis and related spondyloarthropathies Rheum Dis Clin North Am 1995;21:117-28.
25. Gunaydin R, Kaya T, Atay A, Olmez N, Hur A, Koseoglu M. Serum leptin levels in rheumatoid arthritis and relationship with disease activity. South Med J. 2006;99(10):1078-83
26. Kavuncu S, Koç F, Kurt M, Eryüksel B, Ortaç S, Ozdal P, Firat E. Evaluation of serum leptin concentration in Behçet's disease with ocular involvement. Graefes Arch Clin Exp Ophthalmol. 2005;243(11):1158-60
27. Wisłowska M, Rok M, Stepień K, Kuklo-Kowalska A. Serum leptin in systemic lupus erythematosus. Rheumatol Int. 2008;28(5):467-73
28. Özdemir M, Okudan N, Gümüsel M et al: Serum leptin levelsin patients with psoriasis vulgaris. T Klin J Dermatol 2006;16:98-101.
29. Aktan Ş, Rota S, Erdoğan B et al: A Role of leptin in psoriasis? Turk J Med Sci 2007;37:135-8.
30. Türkan Gönül, Pınar Yüksel Başak, Yusuf Kara, Vahide Baysal Akkaya, Hüseyin Vural PM Psoriasisli Hastalarda Serum Leptin Düzeylerinin Araştırılması [Investigation of Serum Leptin Levels in Psoriatic Patients] Turkderm , 2009; 43(2) 48–52
31. Mustafa Güler, Erhan Çapkın, Murat Karkucak, Teoman Aydın, Ayşegül Küçükali Türkyılmaz, Adem Karaca, Ferhat Gökmen, Ahmet Alver, Emine Poyraz. Plasma leptin status and the relationship between different medical treatments used in ankylosing spondylitis .Nobel Med 2013; 9(2): 109-13
32. Toussirot E, Streit G, Nguyen N, et al. Adipose tissue, serum adipokines, and ghrelin in patients with ankylosing spondylitis. Metabolism 2007;10: 1383-9.
33. Park MC, Lee SW, Choi ST, Park YB, Lee SK. Serum leptin levels correlate with interleukin-6 levels and disease activity in patients with ankylosing spondylitis. Scand J Rheumatol. 2007;36(2):101-6.
34. Derdemezis CS1, Filippatos TD, Voulgari PV, Tselepis AD, Drosos AA, Kiortsis DN. Leptin and adiponectin levels in patients with ankylosing spondylitis. The effect of infliximab treatment. Clin Exp Rheumatol. 2010;28(6):880-3.
35. Kim KJ1, Kim JY, Park SJ, Yoon H, Yoon CH, Kim WU, Cho CS. Serum leptin levels are associated with the presence of syndesmophytes in male patients with ankylosing spondylitis. Clin Rheumatol. 2012;31(8):1231-8.