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      Visfatin and chemerin levels correspond with inflammation and might reflect the bridge between metabolism, inflammation and fibrosis in patients with systemic sclerosis

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          Abstract

          Introduction

          Adipokines are regulatory molecules which act as mediators of the inflammatory, fibrotic and metabolic processes by interacting with the immune system.

          Aim

          We hypothesized that chemerin and visfatin by pro-inflammatory properties play a significant role in inflammation in systemic sclerosis. To address this hypothesis, we determined serum chemerin and visfatin levels in SSc patients, compared with the control group and defined the correlations with clinical and laboratory parameters in SSc patients.

          Material and methods

          The study included 48 Caucasian female patients with SSc and 38 healthy subjects of the control group. Serum concentrations of selected adipokines were measured using commercially available ELISA Kits.

          Results

          Patients with SSc had higher chemerin levels (209.38 ±55.35 ng/ml) than the control group (182.71 ±33.94 ng/ml) and the difference was statistically significant ( Z = 2.14, p = 0.032). The highest chemerin levels were found in dcSSc patients (242.46 ±95.82 ng/ml). We indicated a positive correlation of chemerin and visfatin with levels of inflammatory markers: CRP ( r = 0.35, p = 0.013 for chemerin; r = 0.41, p = 0.003 for visfatin) and ESR ( r = 0.31, p = 0.03 for chemerin; r = 0.30, p = 0.03 for visfatin). What is more, chemerin manifested a statistically significant positive correlation with the concentration of complement component C3 ( r = 0.47, p = 0.001) and C4 ( r = 0.29, p = 0.049), whereas visfatin correlated with C4 levels ( r = 0.32, p = 0.029).

          Conclusions

          The results of our study indicate that chemerin and visfatin as pro-inflammatory cytokines might represent new markers corresponding with inflammation in systemic sclerosis and might reflect the bridge between metabolism, inflammation and potentially, chemerin may also link inflammation with skin and lung fibrosis.

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          Most cited references74

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          A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group.

          Serum creatinine concentration is widely used as an index of renal function, but this concentration is affected by factors other than glomerular filtration rate (GFR). To develop an equation to predict GFR from serum creatinine concentration and other factors. Cross-sectional study of GFR, creatinine clearance, serum creatinine concentration, and demographic and clinical characteristics in patients with chronic renal disease. 1628 patients enrolled in the baseline period of the Modification of Diet in Renal Disease (MDRD) Study, of whom 1070 were randomly selected as the training sample; the remaining 558 patients constituted the validation sample. The prediction equation was developed by stepwise regression applied to the training sample. The equation was then tested and compared with other prediction equations in the validation sample. To simplify prediction of GFR, the equation included only demographic and serum variables. Independent factors associated with a lower GFR included a higher serum creatinine concentration, older age, female sex, nonblack ethnicity, higher serum urea nitrogen levels, and lower serum albumin levels (P < 0.001 for all factors). The multiple regression model explained 90.3% of the variance in the logarithm of GFR in the validation sample. Measured creatinine clearance overestimated GFR by 19%, and creatinine clearance predicted by the Cockcroft-Gault formula overestimated GFR by 16%. After adjustment for this overestimation, the percentage of variance of the logarithm of GFR predicted by measured creatinine clearance or the Cockcroft-Gault formula was 86.6% and 84.2%, respectively. The equation developed from the MDRD Study provided a more accurate estimate of GFR in our study group than measured creatinine clearance or other commonly used equations.
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            2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative.

            The 1980 American College of Rheumatology (ACR) classification criteria for systemic sclerosis (SSc) lack sensitivity for early SSc and limited cutaneous SSc. The present work, by a joint committee of the ACR and the European League Against Rheumatism (EULAR), was undertaken for the purpose of developing new classification criteria for SSc. Using consensus methods, 23 candidate items were arranged in a multicriteria additive point system with a threshold to classify cases as SSc. The classification system was reduced by clustering items and simplifying weights. The system was tested by (1) determining specificity and sensitivity in SSc cases and controls with scleroderma-like disorders, and (2) validating against the combined view of a group of experts on a set of cases with or without SSc. It was determined that skin thickening of the fingers extending proximal to the metacarpophalangeal joints is sufficient for the patient to be classified as having SSc; if that is not present, seven additive items apply, with varying weights for each: skin thickening of the fingers, fingertip lesions, telangiectasia, abnormal nailfold capillaries, interstitial lung disease or pulmonary arterial hypertension, Raynaud's phenomenon, and SSc-related autoantibodies. Sensitivity and specificity in the validation sample were, respectively, 0.91 and 0.92 for the new classification criteria and 0.75 and 0.72 for the 1980 ACR classification criteria. All selected cases were classified in accordance with consensus-based expert opinion. All cases classified as SSc according to the 1980 ACR criteria were classified as SSc with the new criteria, and several additional cases were now considered to be SSc. The ACR/EULAR classification criteria for SSc performed better than the 1980 ACR criteria for SSc and should allow for more patients to be classified correctly as having the disease.
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              Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee.

              (1980)
              A multicenter, ongoing study of early-diagnosed cases of systemic sclerosis and comparison patients with systemic lupus erythematosus, polymyositis/dermatomyositis, and Raynaud's phenomenon was conducted in order to develop classification criteria for systemic sclerosis. Preliminary criteria are proposed namely, the finding of either the sole major criterion, i.e., proximal scleroderma, or two or more of the minor criteria, i.e., 1) sclerodactyly, 2) digital pitting scars of fingertips or loss of substance of the distal finger pad, and 3) bilateral basilar pulmonary fibrosis. When applied to the case and comparison patients included in this study, these proposed criteria had a 97% sensitivity for definite systemic sclerosis and 98% specificity.
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                Author and article information

                Journal
                Postepy Dermatol Alergol
                Postepy Dermatol Alergol
                PDIA
                Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii
                Termedia Publishing House
                1642-395X
                2299-0046
                06 November 2019
                October 2019
                : 36
                : 5
                : 551-565
                Affiliations
                [1 ]Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
                [2 ]Department of Psychiatric Nursing, Medical University of Lublin, Lublin, Poland
                Author notes
                Address for correspondence: Karolina Sawicka MD, Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, 13 Radziwiłłowska St, 20-080 Lublin, Poland. phone/fax: +48 81 532 36 47. e-mail: k.sawicka10@ 123456gmail.com
                Article
                79104
                10.5114/ada.2018.79104
                6906965
                31839772
                562cc600-9a2e-41a3-ab8e-13b0af55e828
                Copyright: © 2018 Termedia Sp. z o. o.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                : 09 August 2018
                : 24 August 2018
                Categories
                Original Paper

                visfatin,chemerin,systemic sclerosis
                visfatin, chemerin, systemic sclerosis

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