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Abstract
IntroductionThe current markers of disease activity in Takayasu arteritis (TA) are insufficient for proper assessment. We investigated circulating levels of unacylated and acylated ghrelin, leptin and adiponectin and their relationships with disease activity in patients with TA.MethodsThis study included 31 patients with TA and 32 sex-, age- and body mass index-matched healthy controls. Disease activity was assessed in TA patients using various tools, including Kerr's criteria, disease extent index-Takayasu, physician's global assessment, radiological parameters, and laboratory markers. Plasma unacylated and acylated ghrelin, and serum leptin and adiponectin levels were measured using an enzyme-linked immunosorbent assay.ResultsUnacylated and acylated ghrelin levels were found to be significantly lower in TA patients than that in healthy controls. Patients with active disease had lower unacylated ghrelin levels than those with inactive disease and had lower acylated ghrelin levels than healthy controls. Ghrelin levels were negatively correlated with various parameters of disease activity. The leptin/ghrelin ratio was significantly higher in TA patients than controls. It was positively correlated with disease activity. There was a positive correlation between unacylated and acylated ghrelin and a negative correlation between leptin and ghrelin. There was no statistical difference in adiponectin levels between TA patients and controls. The radiological activity markers were positively correlated with other parameters of disease activity.ConclusionsThis study suggests that plasma unacylated and acylated ghrelin levels may be useful in monitoring disease activity and planning treatment strategies for patients with TA. The serum leptin level and leptin/ghrelin ratio may also be used to help assess the disease activity.
Highlights
The current markers of disease activity in Takayasu arteritis (TA) are insufficient for proper assessment
We found that the leptin/ghrelin ratio was significantly higher in TA patients than in healthy controls
In contrast to our results, this study showed that active anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is characterized by increased serum ghrelin and decreased serum leptin, both of which return to normal with successful therapy [22]
Summary
The current markers of disease activity in Takayasu arteritis (TA) are insufficient for proper assessment. The disease is characterised by an acute phase with constitutional symptoms and followed by a vascular phase presented with symptoms due to stenosis, occlusion or aneurysms. These phases often overlap during the disease course [1]. ESR is increased in nearly half of the patients in clinical remission, while it is normal in 28% of the patients with active disease [7]. The current criteria for the assessment of disease activity in TA [7] are not sufficient either
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