| Abstract |
Inflammatory bowel diseases (IBD) are chronic relapsing diseases of the digestive system. Dr Burill B Crohn was the first, who observed the characteristic hypertrophic appearance of the mesenteric white adipose tissue (WAT) in the disease that bears his name (fat wrapping). During the last 10 years, a new role has been revealed for WAT and deals with the production, under certain circumstances, of highly active molecules, collectively known as “adipokines”, which participate in the inflammatory process. Among these products, four hormones, leptin, adiponectin, resistin and ghrelin seem to hold a pivotal role.
Leptin is exclusively produced by adipose tissue. It is a crucial regulator of apetite and metabolism. It is increased in various inflammatory conditions. Adiponectin is also secreted, under normal condition, from the adipose tissue. It induces β-oxidation of fatty acids in the muscles and improves glucose metabolism by increasing tissue sensitivity to insulin. It also prevents the evolution of inflammation and possibly atheromatosis. Resistin is not exclusively produced by WAT and seems to hold an ambiguous role in insuline resistance. Ghrelin is the endogenous substrate of growth hormone secretagogue receptors (GHS-Rs). Its role includes the induction of growth hormone, adrenocorticotropin hormone and prolactin secretion, the induction of apetite and the participation in energy homeostasis. The role of adiponectin, resistin and ghrelin in the IBD patients is unknown.
In the present study, we investigated (a) serum concentration of leptin, adiponectin, resistin and ghrelin in IBD patients compared to healthy controls (HC) and its relationship with markers of inflammation and disease clinical parameters, (b) the existence of any relationship between measured adipokines and the apetite and body mass index disorders observed in IBD patients and (c) serum concentration of leptin, adiponectin and resistin in IBD patients before and after infliximab (IFX) treatment.
Leptin concentration was lower in the IBD patients, especially those with ulerative colitis, compared to HC. IFX therapy led to a non significant increase in leptin concentration. Adiponectin concentration was higher in the IBD patients. IFX therapy led to a non significant decrease in adiponectin concentration. Resistin and ghrelin concentration was particularly higher in the IBD patients compared to HC. IFX treatment resulted in a significant decrease in resistin concentration. No relationship was found between the above mentioned adipokines and the markers of
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inflammation or the clinical parametres of the disease, indicating the primary nature of the alteration of their serum concentration.
The results of the present study describe the significant change that is observed in the serum concentration of leptin, adiponectin, resistin and ghrelin in the IBD patients compared to HC and also the crucial impact that anti-TNFα agents exert on these molecules. So through these results, the important role of WAT in IBD is revealed offering an open scientific field for further investigation.
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Διαταραχές του λίπους και ο ρόλος των ορμονών της ενεργειακής ομοιόστασης σε ασθενείς με ιδιοπαθή φλεγμονώδη εντερική νόσο
