Adipocytokine and ghrelin levels in patients with takayasu's arteritis and the relationship of these parameters with disease activity

Objective: The follow-up of the disease activity is of great importance as it requires intense treatment in active period of Takayasu?s arteritis (TA). Today, clinical and laboratory activity criteria alone are not satisfactory in follow-up. This study aims to investigate serum leptin, adiponectin and plasma ghrelin and acylated ghrelin levels and the relationship of these parameters with the disease activityMaterial and method: 31 TA patients and 32 healthy controls were included in the study. In TA patients, the disease activity was evaluated based on the NIH activation criteria, DEI.TAK scoring, ?DEI.TAK-physician?s global opinion (PGO)? and radiological investigations (B-mode and Doppler USG and MR angiography). Serum leptin, adiponectin and plasma ghrelin and acylated ghrelin levels were measured by ELISA in all patients and controls. Mann-Whitney U test and Pearson?s correlation analysis was used in the comparison of the groups and testing the inter-variety correlations, respectively.Results: Of the 31 TA patients, 29 were female and 3 were male and the mean age was 44.2 years. 18 patients with type 5 (%58.1) had retention. 18 of the patients with TA (%58) used corticosteroids.Twenty % of TA patients were active based on NIH activation criteria; 19.4% were active, 22.6% were persistent and 58% were inactive based on ?DEI.TAK- PGO? and 33% were active based on the radiological findings. There was a positive correlation between NIH activation criteria and DEI.TAK scoring ?DEI.TAK-PGO? and also radiological activity (r=0.566, p=0.001; r=0.603, p=0.001; r=0.409, p=0.031, respectively). Serum ESH, WBC and % neutrophil levels were higher in TA patients than controls (p=0.017, p=0.002 and p ? 0.001, respectively).Plasma ghrelin (319.3±202.6 pg/ml) and acylated ghrelin (120.5±94.4 pg/ml) levels in TA patients were significantly lower than controls (623.2±270 pg/ml and 180.9±128.7 pg/ml respectively), (p ? 0.001 and p=0.031, respectively). Ghrelin levels were significantly lower in active patients than inactive patients according to NIH activation criteria and ?DEI.TAK-PGO? (p=0.041 and p=0.016 respectively).No difference was found between leptin and adiponectin levels in TA patients and healthy controls. However, a significant negative correlation was found between leptin levels and ghrelin and acylated ghrelin levels in TA patients (r=0.344, p=0.006 and r=0.389, p=0.002, respectively). There was a significant positive correlation between mean carotid intima-media thickness (IMT) measurements and adiponectin levels in TA patients (p=0.001 and p=0.004, respectively).Conclusion: Ghrelin levels were considered to be useful in monitoring the disease activity and adjusting the treatment plan in TA. DEI.TAK scoring, ?DEI.TAK- PGO? and radiological activity parameters which are in accordance with NIH activation criteria can also be used for disease follow-up.Key words: Takayasu?s arteritis, adiponectin, leptin, ghrelin, acylated ghrelin, NIH activation criteria, DEI.TAK scoring.