Assessment of serum Vaspin level in Vitiligo Abstract Background

Assessment of serum Vaspin level in Vitiligo

Abstract
Background: Metabolic disorders and peculiar ranges of circulating adipokines have been stated in sufferers with vitiligo
Objective: The aim of this study was to investigate the differences in the correlations of vaspin plasma levels and metabolic parameters between two groups: patients with vitiligo and healthy persons.
Patients and methods: We measured plasma levels of vaspin, metabolic parameters, and metabolic syndrome (MS) in 32 patients with vitiligo and 32 healthy controls (HC) subjects. Patients with vitiligo were evaluated Vitiligo Disease Activity Score (VIDA)for evaluating vitiligo activity and the Vitiligo Area Severity Index (VASI)To determine the percentage of vitiligo involvement. The Dermatology Life Quality Index (DLQI) was used to evaluate measures how much vitiligo has affected patient’s life. Body mass index (BMI), weight, waist circumference (WC), fasting glucose, and triglyceride levels
Results :Among study group were statistically higher than those of the healthy controls (p Z 0.001, p ; 0.001, p ; 0.001, p Z 0.027, and p Z 0.001 respectively). Plasma levels of vaspin were 0.978 ng/ml in patients with vitiligo and 0.292 in the HC group (p ; 0.001).
Conclusion: Our study revealed associations between metabolic parameters /metabolic syndrome and vaspin plasma concentrations in patients with vitiligo. Vaspin can play a specific role in the pathogenesis of metabolic disorders in these subjects and can be a specific indicator substance in vitiligo.

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Introduction
Metabolic syndrome (MS) is a complex of interrelated risk factors for cardiovascular diseases, diabetes mellitus, and stroke. Vitiligo is an acquired depigmenting skin disease of unknown origin and multifactorial pathogenesis. There is growing evidence that vitiligo can also be related to systemic inflammatory disorders such as obesity and MS (1).
Recently, several authors have proposed the association between MetS and vitiligo(2). This hypothesis is based upon increased proinflammatory cytokines in vitiligo(3). Among the many additional hypotheses: increased homocysteine levels of vitiligo patients, lack of the anti-inflammatory effect of melanin, and direct damage from reactive oxygen radicals(4). Impairment of lipid metabolism and insulin resistance may also be associated with vitiligo(5).
Leptin, adiponectin, and vaspin are adipokines, which are known to be three bioactive molecules secreted by adipose tissue (6). Primary conditions related to obesity, several health problems, including increases in the risks for insulin resistance, type 2 diabetes, fatty liver disease, hypertension, dyslipidemia, atherosclerosis, dementia, and cancers might be related to adipocyte and adipose tissue dysfunction (7).
Adipokines play important roles in the relationship between adipose tissue and other tissues and organs, including the vascular system, liver, skeletal muscle, brain, and others. The importance of altered leptin signaling in the development of obesity and diabetes was discovered when a mutation in the leptin receptor gene caused obesity and diabetes in “db/db mice” (8).
Adiponectin is the most abundant protein secreted by the white adipose tissue and has important anti-atherogenic, anti-inflammatory, and anti-diabetic properties (9) Following the investigation of adipokines in the etiology of obesity, visceral adipose tissue-derived serpin (vaspin) has gained interest in obesity research. The vaspin expression has been observed in the adipose tissue, stomach, liver, and pancreas in humans. The exact mechanisms by which vaspin is associated with impaired glucose homeostasis and insulin sensitivity are not yet fully understood. Vaspin inhibits a protease that plays a role in the degradation of a hormone or molecule with direct or indirect glucose-lowering effects, according to available data (10).
The administration of vaspin to obese mice has been shown to improve glucose tolerance, insulin sensitivity, and altered gene expression of candidate genes for insulin resistance (11). In addition, central vaspin administration leads to reduced food intake and has sustained blood-glucose lowering effects (12).
To the best of our knowledge, no study in the literature has yet investigated the relationship between plasma vaspin levels, metabolic parameters, and in patients with vitiligo. The first aim of this study was to compare plasma vaspin levels and metabolic parameters between two groups: patients with vitiligo and a group of healthy persons. The second aim of this study was to examine the relationship between vaspin and MS parameters in both groups.
Patients and methods
This case-control study was conducted on vitiligo patients with A total of 64 individuals were included: 32 vitiligo patients and 32 individuals as controls. The control group included healthy, age-matched and sex-matched volunteers who had no dermatological or systemic diseases.
Patients with vitiligo were evaluated Vitiligo Disease Activity Score (VIDA)for evaluating vitiligo activity and the Vitiligo Area Severity Index (VASI)To determine the percentage of vitiligo involvement.T he Dermatology Life Quality Index (DLQI) was used to evaluating measures how much vitiligo has affected patient's life.
Exclusion criteria were as follows: age below 16 years, vitiligo lasting for less than 6 months, alcohol consumption, smoking, psoriasis, rheumatoid arthritis, ankylosing spondylitis, chronic obstructive pulmonary diseases, thyroid dysfunction, autoimmune diseases, liver diseases, malignancy, use of oral immunosuppressive or systemic corticosteroids, infections, pregnancy, lactation, and women on hormone replacement therapy.
The diagnosis of MS was made according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III modified criteria: (I) waist circumference (WC) 35 inches (88 cm) in women and 40 inches (102 cm) in men; (II) plasma triglyceride level over 150 mg/dl or taking medication due to a high triglyceride level; (III) low HDL cholesterol level or taking medication due to low HDL (less than 50 mg/dl in women and 40 mg/dl in men); (IV) fasting blood glucose (sugar) over 100 mg/dl or taking medication for high blood glucose; and (V) blood pressure exceeding 130/85 mmHg (13).
Sample collection and analysis
After a 12-h fasting period, peripheral venous blood samples were collected, centrifuged at 4000 rpm for 10 min, and stored at 80 ?C. All samples were thawed only once before analyses. Serum fasting glucose, total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and insulin levels were determined. Glucose and lipid parameters were analyzed in a Roche Cobas c501 autoanalyzer with the original reagents (Roche Diagnostics, Germany). We measured insulin levels by an electrochemiluminescent method in a Roche Cobas e601 analyzer with reagents from the manufacturer (Roche Diagnostics, Germany). Vaspin serum levels were determined quantitatively by enzyme-linked immunosorbent assay (ELISA) with an ELISA microplate strip washer (ELX50; BioTek Instruments, USA) and ELISA microplate reader (ELX808; BioTek Instruments, USA). Vaspin was studied using a commercially available kit from MyBioSource, Inc. (San Diego, CA, USA). In this assay system, the intra-assay and inter-assay coefficient of variations were consistently below 10%. The minimum detectable dose of human vaspin is 37.5 pg/ml.
Statistical analyses
For statistical analysis, SPSS software for Windows (version 19.0) was used. For the comparison of the demographic and clinical data, the independent samples Student’s t-test was used for quantitative variables; the chi-square test was used for categorical variables. Associations between various parameters were investigated using Pearson’s correlation analysis. A P value of

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