Circulating ghrelin and apelin levels in nonobese psoriasis vulgaris patients

Abstract

Background The metabolism and immune system are linked via a network of many mediators known as adipokines. Ghrelin and apelin-36 are unique adipokines; however, their role in psoriasis, an immune-mediated disease, remains unclear. Objective To detect the serum levels of ghrelin and apelin-36 in psoriasis vulgaris patients in comparison with controls and to correlate their levels with severity of psoriasis, BMI, lipid profile, and glycated hemoglobin (HbA1c). Patients and methods The present case-control study included 70 nonobese psoriasis vulgaris patients and 70 controls. The severity of psoriasis was assessed using the psoriasis area and severity index score. The ghrelin and apelin-36 serum levels, cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and HbA1c were measured. Results Psoriatic patients had significantly higher ghrelin (P<0.001), HbA1c (P<0.001), cholesterol (P<0.001), triglycerides (P<0.001), and low-density lipoprotein (P=0.001) levels and a lower apelin-36 (P<0.001) serum level than controls. Serum ghrelin was negatively correlated with psoriasis area and severity index score (r=-0.75; P<0.001), whereas serum apelin-36 was negatively correlated with HbA1c mean values (r=-0.44; P=0.004) and was found to be a good predictor of prediabetes in psoriatic patients (P=0.012). Nonsignificant correlation between ghrelin and apelin-36 serum levels was observed in psoriatic patients. Conclusion Ghrelin and apelin-36 are dynamic adipokines that might play a role in psoriasis vulgaris pathogenesis. The role of ghrelin and apelin-36 in psoriasis might be mediated through dyslipidemia and impaired glucose metabolism in psoriatic patients, respectively. Targeting both ghrelin and apelin-36 may be of value in management of metabolic syndrome associated with psoriasis. Serum apelin-36 assessment can predict prediabetic state in psoriatic patients.