Association of retinol binding protein4 (RBP4) and ghrelin plasma levels with insulin resistance and disease severity in non-diabetic patients with hidradenitis suppurativa.

Marcos A González‐López,José L Hernández,Ricardo Blanco,Sandra Guiral,Virginia Portilla,Iosune Vilanova,J Gonzalo Ocejo‐Viñals,Cristina Mata

doi:10.1111/exd.14132

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with insulin resistance (IR). Retinol binding protein 4 (RBP4) and ghrelin are two bioactive proteins that have been involved in glucose metabolism and IR, but also in the regulation of immune and inflammatory processes. The aim of this study was to determine the serum levels of RBP4 and ghrelin in patients with HS, and to assess the possible relationship between these levels and IR, disease severity and HS risk. A total of 137 subjects (77 HS patients and 60 controls) without diabetes mellitus were enrolled in this cross-sectional study. Patients with HS had significantly higher RBP4 but lower ghrelin plasma levels than controls, independently of body mass index (BMI). Serum RBP4 levels were positively correlated to disease severity and IR in HS patients. However, we found no association between ghrelin levels and any clinical or laboratory parameters. Moreover, high serum RBP4 and low ghrelin levels were associated with an increased risk for HS. Our results suggest that high RBP4 levels may be a surrogate biomarker for IR in patients with HS. Moreover, increased RBP4 and decreased ghrelin levels could also be independent risk factors for the development of HS.

Highlights

Hidradenitis suppurativa (HS) is a chronic, inflammatory, skin disease of the hair follicle
We found that serum Retinol binding protein 4 (RBP4) levels were significantly increased in HS-patients and positively correlated with disease severity
In this regard, increased plasma levels of this adipokine have been found in other cutaneous diseases, such as contact dermatitis [21]and psoriasis. [22]raised RBP4 concentrations in our study were associated with an increased risk for HS, suggesting that this adipokine might play a role in the pathogenesis of HS.In this respect, it should be noted that RBP4 acts as an immunomodulatory adipocytokine and may induce the release of pro-inflammatory mediators, including TNF-α, IL-1 and IL6.[12]in our HS-patients, serum RBP4 levels were positively associated with insulin resistance (IR) even after adjustment for body mass index (BMI), suggesting that other factors independent of obesity might be implicated in such an association

Summary

Introduction

Hidradenitis suppurativa (HS) is a chronic, inflammatory, skin disease of the hair follicle. IR, a crucial pathophysiological factor for the development of MS and T2DM, and accelerated atherogenesis has been related to the chronic systemic inflammation state found inHS.[6,10] In this regard, it has been suggested thatraisedblood levels of certain proinflammatory cytokines involved in HS pathogenesis, such as IL-1 and IL-6,may induce a proatherogenic and IR-adipokine pattern in HS patients.[1]

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