Serum levels of ghrelin, adipokines, and tumor necrosis factor-α (TNF-α) in patients with juvenile idiopathic arthritis in Assuit University Hospitals: Relation to nutritional status and disease activity

Abstract

Background: In juvenile idiopathic arthritis (JIA) several proinflammatory cytokines are secreted leading to anorexia and weight loss. Objectives: We aimed to measure serum levels of ghrelin, adipocytokines and tumor necrosis factor alpha (TNF-α) in JIA patients. Also, to correlate them with disease activity and patients’ body mass index (BMI). Patients and methods: Sixty-five patients with JIA (40 girls and 25 boys; means ± SD of age were 12.1 ± 3.5 years) and 54 matched healthy controls were evaluated by ELISA to measure levels of ghrelin, leptin, adiponectin and TNF-α and correlate these levels with Juvenile Arthritis Disease Activity Score (JADAS) and patients’ BMI. Results: Thirty-four patients (52.3%) had active disease while 31 (47.7%) had inactive disease. JIA patients had significantly lower level of ghrelin and leptin and significantly higher level of TNF-α than the control group (P ⩽ 0.001, P ⩽ 0.05, P ⩽ 0.001, respectively). Those with active disease had significantly lower level of ghrelin and significantly higher TNF-α level than those with inactive disease (P ⩽ 0.001, P ⩽ 0.01, respectively). Significant positive correlations were found between ghrelin and leptin levels and patients’ BMI (P ⩽ 0.05, P ⩽ 0.01, respectively). Conclusion: Ghrelin and leptin could be considered to be responsible for decreased BMI in patients with JIA, so they might be potential targets of new therapeutic strategies for correction of anorexia and associated weight loss in those patients. Low ghrelin and high TNF-α could be used as useful tools in monitoring disease activity in JIA.

Keywords

• Juvenile idiopathic arthritis
• Ghrelin
• Leptin
• Adiponectin
• TNF-α