Evaluation of the relationship between Nesfatin-1 and celiac disease

Introduction: Celiac disease is an autoimmune, familial inflammatory disease that develops as a result of sensitivity to dietary gluten in genetically predisposed individuals, causes characteristic lesions in the small intestine, and generally progresses with malabsorption and improves clinically with gluten-free diet. In recent years, biochemical and immunohistochemical markers that can be used in the diagnosis and follow-up of celiac disease have become the focus of attention of scientists. Nesfatin-1 is a neurohormone secreted from the hypothalamus and synthesized from nucleobindin 2, known as the satiety peptide, and has effects on the appetite mechanism and nutritional status. In addition to maintaining nutritional balance, Nesfatin-1 plays an important role in glucose homeostasis, lipid metabolism, modulation of gastrointestinal functions, cardiovascular and reproductive functions. It is also a pro-inflammatory peptide along with potent anti-inflammatory, anti-apoptotic and anti-oxidative properties that can improve symptoms of various diseases. In our study, we aimed to investigate the relationship between serum and tissue nesfatin-1 levels and celiac disease diagnosis and disease activity. Material-method: Our study included 37 celiac patients (17 active, 20 remission) and 24 healthy control groups without celiac disease, aged 18-65 years. Pregnancy, malignancy, history of cardiovascular disease, advanced liver and kidney disease, hepatitis B and C infection and acute chorear syndrome in the last six months were not included in the study. Serum nesfatin-1 levels were measured using ELISA kits. Nesfatin-1 expression was investigated immunohistochemically in duodenal pathology blocks. Data were compared statistically. Results: Serum nesfatin-1 was found to be statistically significantly lower in the CD group (0.027). When evaluated as 3 groups as celiac active, celiac remission and control, a statistically significant difference was found (p=0.029). Although there was no significant difference between active-remission, celiac remission was found to be significantly lower in the control group (p=0.026). When tissue nesfatin-1 expression levels were compared, a statistically significant difference was found between the celiac disease group and the control group (p=0.0001). When the celiac group was analyzed in terms of active and remission, a statistically significant difference was found (p=0.001). When the evaluation was made as 3 groups as celiac active, celiac remission and control, a statistically significant difference was found between nesfatin-1 expression levels (p=0.0001). The expression level of nesfatin-1 was lowest in the celiac active group, moderate in the remission group, and highest in the control group. In the celiac disease group, a negative correlation was found between serum nesfatin-1 level and urea, creatinine, potassium, and magnesium, and a positive correlation was found between fat measurements. There was a positive correlation between serum nesfatin-1 level and albumin in the control group. There was a negative correlation between serum nesfatin-1 level and magnesium in the celiac remission group. In the celiac disease group, tissue nesfatin-1 level was positively correlated with urea, and creatinine was positively correlated with TSH. There was a negative correlation between tissue nesfatin-1 expression in the control group and AST, ALT, GGT, LDH, TSH, albumin, phosphorus and BMI. Nesfatin-1 expression and RDW were negatively correlated with MCHC in the celiac active group. In the celiac remission group, a positive correlation was found between tissue nesfatin-1 expression, PLT, total cholesterol,LDL, calcium, phosphorus, urea, and creatinine. The overall accuracy of the ROC curve analysis for the estimation of CD of serum nesfatin-1 value 0.671 (p=0.039);tissue nesfatin-1 value is 0.786 (p=0.001). Optimum cut-off value of serum nesfatin-1 in determining CD is 2047 pg/ml, sensitivity 57%, specificity 58%; The cut-off value of tissue nesfatin-1 in determining CD was found to be 2.5 (0-3), sensitivity 83% and specificity 68%. Conclusions: Serum nesfatin-1 level is a factor determining the presence of celiac disease; We think that the decrease in serum nesfatin-1 levels can be used as a biomarker that can be used for screening in celiac disease. Tissue nesfatin-1 was significantly decreased in the celiac active group, moderate in the remission group and very high in the control group. We think that tissue nesfatin-1 levels can be used as a biomarker that can be used in the diagnosis and disease activity of celiac disease.