THE ROLE OF RESISTIN IN THE PROGRESSION OF NON-ALCOHOLIC FATTY LIVER DISEASE

The aim of the research was to study the relationship between plasma concentrations of resistin and indicators of enzyme and pigment metabolism in patients with non-alcoholic fatty liver disease (NAFLD) and its combination with type 2 diabetes mellitus (DM-2). Materials and methods. On the base of Kharkiv Regional Hospital a total of 90 patients were examined, including patients with NAFLD (n = 20) and its combination with DM-2 with normal body weight (n = 20) and obesity (n = 50), as well as 20 healthy volunteers. A complex of clinical, laboratory and instrumental (including liver biopsy in 9 patients) examinations of patients was performed. Results. A direct relationship was established between the level of resistin and indicators of enzyme and pigment exchange in groups of patients with combined pathology. A significant increase of resistin plasma level, as well as disorders of the liver function were determined in all groups of patients in comparison with the controls. The most marked changes were revealed in patients with combination of NAFLD, DM-2 and obesity. Conclusions. The established relationship between the level of resistin and the indicators of the liver functional state suggests that an increase of resistin level may reflect the presence of impaired liver function in patients with NAFLD in combination with DM-2, predicting the progression of NAFLD. In order to detect the disorders of liver function in patients with DM-2, it is recommended to determine the level of resistin in patients with NAFLD, especially when concomitant obesity is present. Patients with resistin level (> 8.06 ± 0.23 ng/ml) should be considered at risk of NAFLD progression.

Positive Correlation of Serum Resistin Level with Peripheral Artery Disease in Patients with Chronic Kidney Disease Stage 3 to 5

Chronic kidney disease (CKD) is associated with higher risk of cardiovascular disease-related ischemic events, which includes peripheral arterial disease (PAD). PAD is a strong predictor of future cardiovascular events, which can cause significant morbidity and mortality. Resistin has been found to be involved in pathological processes leading to CVD. Therefore, we aim to investigate whether resistin level is correlated with PAD in patients with non-dialysis CKD stage 3 to 5. There were 240 CKD patients enrolled in this study. Ankle-brachial index (ABI) values were measured using the automated oscillometric method. An ABI value < 0.9 defined the low ABI group. Serum levels of human resistin were determined using a commercially available enzyme immunoassay. Thirty CKD patients (12.5%) were included in the low ABI group. Patients in the low ABI group were older and had higher resistin levels as well as higher diabetes mellitus, hypertension and habit of smoking, and lower estimated glomerular filtration rate than patients in the normal ABI group. After the adjustment for factors that were significantly associated with PAD by multivariate logistic regression analysis, age and serum resistin level were independent predictors of PAD. A high serum resistin level is an independent predictor of PAD in non-dialysis CKD stage 3 to 5.

The role of resistin and its relation to other pathogenetic factors of the chronic kidney disease development

Chronic kidney disease (CKD) is the leading cause of death from non-communicable diseases, and its prevalence in 2017 ranged from 8.5 to 9.8%. Depending on the stage of CKD, stage 1 was diagnosed in 3.5%, stage 2 in 3.2% and stage 3 in 7.6%, while stages 4 and 5 took place in 0.4 and 0.1% of the world’s population respectively. Obesity also contributes to the increase in the prevalence and severity of CKD, and their combination occurs in 3.1% of patients. Kidney damage and their structural and functional changes in patients with obesity are associated with high metabolic activity of adipose tissue, due to the synthesis of adipocytokines, including resistin. The purpose of the work: to study changes of resistin level in the blood in patients with early stages of chronic kidney disease, its relation to the level of endothelin, markers of lipid metabolism and inflammation. Materials and methods: 70 patients with stage 1 and 88 patients with stage 2 of CKD with different stages of obesity were examined. Glomerular filtration rate (GFR) was calculated by the formula CKD-EPI based on creatinine, cystatin C and their combination (CKD-EPIcysC / cr). The levels of cystatin C, resistin, tumor necrosis factor-alpha (TNF-α) and endothelin-1 were determined by enzyme-linked immunosorbent assay. Determination of total cholesterol and low-density lipoprotein cholesterol levels in the blood serum was performed by colorimetric method. Statistical analysis of the results was performed with the help of Statistica 6.0 statistical software package using Student’s t-test and Spearman’s rank correlation coefficient. Results: an increase of the resistin level in the blood by 1.3 times in the patients with stage 1 CKD and by 1.6 times in the patients with stage 2 CKD and obesity was determined (p1.2 &lt; 0.05), and there was a weak correlation between its concentration in the blood and body mass index. A significant average negative correlation between resistin and GFR was detected. Increased serum resistin level correlates with increased TNF-α. In patients of both groups, the level of resistin and LDL increases simultaneously, and the correlation between them increases as CKD progresses. Similar changes are observed with respect to increasing concentrations of resistin and endothelin-1. Thus, an increase of resistin level in the blood in patients with the early stages of CKD initiates a number of pathological changes, such as systemic inflammation, hyperlipidemia and endothelial dysfunction.

Serum resistin is predictive marker of development of new digital ulcers in systemic sclerosis

Systemic sclerosis (SSc) is autoimmune disease characterized by endothelial dysfunction and microvascular damage. Resistin has been implied in microvascular dysfunction. Objective of this study is to evaluate the association between baseline resistin and development of new digital ulcers (DUs) in SSc patients. At baseline, serum resistin has been assessed in 70 female SSc patients and 26 healthy controls (HC). In SSc patients, clinical assessment was performed at baseline and after a 52-weeks follow-up. Serum resistin level was increased in SSc patients compared to HC [5.89 ng/ml (2.5 ng/ml–8.1 ng/ml) vs 2.3 ng/ml (0.4 ng/ml–2.4 ng/ml), p = 0.0004)]. Resistin was lower (p = 0.005) in SSc patients with early capillaroscopic pattern than patients with active or late capillaroscopic pattern [2.49 ng/ml (0.89 ng/ml–5.81 ng/ml) vs 7.11 ng/ml (3.48 ng/ml–11.35 ng/ml) and 6.49 ng/ml (3.35 ng/ml–8.87 ng/ml), respectively]. After a 52-weeks follow-up, 34 (48.6%) patients developed new DUs. Median serum resistin was significantly higher in patients with new DUs than in patients without new DUs [6.54 ng/ml (3.35 ng/ml–11.02 ng/ml) vs 4.78 ng/ml (1.06 ng/ml–7.6 ng/ml), p = 0.019]. Kaplan–Meier curves show a significantly reduced free survival from DUs in patients with increased resistin (p = 0.002). In multivariate analysis, resistin is associated with the development of new DUs. Increased serum resistin level is a predictive marker of new DUs in SSc.

The Relationship between Resistin Level and the Degree of Non-Alcoholic Fatty Liver Disease (NAFLD)

Background: NAFLD is a metabolic syndrome that manifests in the liver and is associated with type 2 diabetes mellitus (type 2 DM), insulin resistance, obesity and hyperlipidemia. The number of sufferers continues to increase worldwide in line with the increasing prevalence of obesity and diabetes. Resistin is a potential marker for NAFLD, which also have an important relationship with obesity and insulin resistance. Purpose: to analyze the relationship between resistin level and the degree of NAFLD. Methods: This cross sectional study was conducted at the Gastroentero-hepatology Department of Haji Adam Malik General Hospital, Medan, from January to March 2020. Patients with NAFLD diagnosed with abdominal ultrasound underwent measurement of body mass index (BMI), examination of resistin levels, fasting blood glucose, platelet count, albumin, AST and ALT, and the degree of NAFLD Fibrosis Score (NFS) was determined. Results: From 67 samples, based on abdominal ultrasound, the largest proportion was grade I NAFLD (40.4%). There was a statistically significant relationship between resistin levels and the degree of NAFLD (p value <0.01), NAFLD comorbid in both type 2 DM and BMI ≥ 23 kg/m2 (p value <0.001), NFS with the degree of NAFLD (p value <0.001), and also resistin levels with the degree of NFS (p value <0.001). Conclusion: Significant relationship was found between resistin level and the degree of NAFLD (p value <0.001) and also between resistin levels and the degree of NAFLD Fibrosis Score (NFS) (p value <0.001). Keywords: resistin, NAFLD, NFS, diabetes

The Impact of Diet and Fibre Fractions on Plasma Adipocytokine Levels in Prediabetic Adults

The impact of diet and fibre fractions on adipocytokines in obese subjects with a risk of diabetes has not been investigated in detail yet. The purpose of the study is to evaluate the effects of a 12-month lifestyle intervention with different fibre profiles (resistant starch (RS)—rich fibre, or ordinary food fibre profiles) on adipocytokine levels. Fifty participants are divided into two groups (RS group and Fibre group). The groups differ only in the percentage of the recommended level of the RS consumed as a fraction of the same total fibre amount. The applied dietary intervention includes intake of 7531 KJ/daywith a total fibre portion of 25–35 g/dayfor both groups that includes 15 g/day of RS for the RS group only. The levels of leptin, adiponectin, apelin, resistin, tumor necrosis factor (TNF)-alpha and C-reactive protein (CRP) are measured, and their relationship to anthropometric and biochemical parameters is estimated. Along with significant body weight loss, only leptin is significantly reduced by 13% in the RS group while in the Fibre group, apelin levels are significant (−21%). Polynomial regression shows a negative correlation between RS intake and adiponectin (R2 = 0.145) and resistin level (R2 = 0.461) in the RS group. This study indicates the possibility that fibre fractions differently influence the outcome of lifestyle interventions, as well as their adipocytokine levels, in obese prediabetic adults.

AB0415 SERUM RESISTIN LEVEL IN SYSTEMIC LUPUS ERYTHEMATOSUS: RELATION TO LUPUS NEPHRITIS AND DISEASE ACTIVITY

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting different organs and systems.. Adipokines have recently been implicated as mediators of immune and inflammatory processes. Human resistin is a cytokine that induces low-grade inflammation by stimulating monocytesObjectives:The aim of this work is to assess the serum level of resistin in SLE patients and to detect its relation to lupus nephritis, and disease activityMethods:40 patients with SLE with age ranged between 18-48 years and 20 healthy age, sex and BMI matched volunteer were enrolled in this study. According to the presence or absence of lupus nephritis (LN), patients were classified into two subgroups Full history, clinical examination and laboratory investigations were performed for all patients including serum resistin levelResults:The level of serum resistin was higher in SLE patients than the controls(p=0.001).Also, serum resistin levels were higher in patients with lupus nephritis than those without nephritis(p= 0.02).Serum resistin level correlated positively with the levels of ESR(p< 0.001), CRP(p= 0.005),Anti-dsDNA(p= 0.002) and serum urea(p= 0.002).Serum resistin levels correlated negatively with hemoglobin levels(p= 0.001) and levels of C3(p< 0.001) and C4(p< 0.001).There was a significant positive correlation between serum resistin level and the presence of albumin(p= 0.001),RBCs(p= 0.003),pus cells(p= 0.001) and casts(p< 0.001) in urine and also with the levels of 24 hour urinary protein and protein/ creatinine ratio(p<0.001).Serum resistin level was found to be strongly correlated with SLEDAI(p< 0.001).No correlation was found between serum resistin levels and ISN/RPS classification of renal biopsy.Conclusion:Serum resisitin level can be used as a marker of inflammation, nephritis,disease activity in patients with SLE.Disclosure of Interests: :None declared