Predictive Value of Serum and Urinary Adiponectin in Systemic Lupus Erythematosus Activity and Lupus Nephritis

Document Type : Original Article

Authors

1 Department of Internal Medicine, Tanta University; Egypt

2 Department of Internal Medicine,Tanta University; Egypt

3 Department of Clinical Pathology, Tanta University; Egypt

4 Department of Pathology, Tanta University; Egypt

Abstract

Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by chronic
inflammation. Lupus nephritis is a severe manifestation of SLE affecting about 50% of SLE patients with high morbidity
and mortality. Adiponectin has anti-inflammatory properties. Adiponectin could be a factor linking inflammation in SLE
and lupus nephritis (LN). Aim of the Work: To assess the level of serum & urinary adiponectin in SLE patients and to
detect any relation between serum & urinary adiponectin levels and SLE activity and lupus nephritis. Subjects and
Methods: This study included 30 female SLE patients and 15 female age matched healthy controls. SLE patients were
subjected to full history taking, clinical examination and laboratory investigations of SLE & LN. Disease activity and
renal involvement were assessed using SLE Disease Activity Index (SLEDAI) and Renal SLEDAI respectively. Patients
were divided into active versus inactive and LN versus non-LN. Renal biopsies were taken from LN subgroup. Serum &
urinary levels of adiponectin were measured using enzyme-linked immunosorbent assay (ELISA) in all subjects. Results:
Significantly higher serum & urinary adiponectin level was found in SLE patients when compared with controls.
Significantly higher serum & urinary adiponectin level was found among active SLE patients when compared with
inactive patients as well as among patients with LN when compared to patients without LN. Significantly higher serum &
urinary adiponectin level was found among inflammatory LN class (III & IV) patients when compared to noninflammatory
LN class (I & II). Serum & urinary adiponectin had a significant positive correlation with SLEDAI, renal
SLEDAI, ESR 1st hour, proteinuria , anti-ds (DNA) titre and LN class while inverse correlation with C3 titre and C4 titre ,
also inverse correlation between urinary adiponectin and creatinine clearance were observed. Conclusion: Serum &
urinary adiponectin levels are elevated in SLE patients and strongly associated with lupus activity & LN, so they may
consider promising biomarkers for prediction of SLE activity & renal involvement especially urinary adiponectin in lupus nephritis.

Keywords

Egyptian Journal of Rheumatology and Clinical Immunology
Volume 2, Issue 1
January 2014
Pages 53-62

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