Study of The Role of Nicotinamide Phosphoribosyl Transferase/Visfatin in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

Diab, Wael; Abd Elmaged, Mona; Tayel, Manal; El Sayed, Eman; Barakat, Mohamed; Ramadan, Ragaa

doi:10.21608/ejrci.2015.9302

Study of The Role of Nicotinamide Phosphoribosyl Transferase/Visfatin in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

Document Type : Original Article

Authors

¹ Departments of Internal Medicine, Rheumatology Unit, Alexandria University; Egypt

² Departments of Diagnostic Radiology, Alexandria University; Egypt

³ Chemical Pathology, Medical Researches Institute; Alexandria University; Egypt

10.21608/ejrci.2015.9302

Abstract

Introduction: Lupus nephritis (LN) is common and carries a high burden of morbidity in SLE patients. The adipokine ‘‘visfatin’’ is highly expressed in visceral fat, exerts several pro inflammatory functions and was demonstrated as a marker of endothelial dysfunction (ED) in chronic kidney disease (CKD). Aim of the work: To evaluate the state of serum visfatin in SLE patients and to detect its possible correlation to disease activity and kidney affection. Also, to define a possible correlation between the level of visfatin before and after a treatment regimen of combined mycophenolate mofetil and corticosteroids. Patients and Methods: visfatin was assayed using enzyme-linked immunosorbent assay (ELISA), chemical and immunological markers of SLE and LN were measured in 50 SLE patients (included 25 patients with LN and 25 patients without LN), and compared with 25 age and sex matched healthy controls. Disease activity was assessed using SLE Disease Activity Index (SLEDAI). Renal biopsies were taken from LN subgroup and were classified according to the modified WHO classification.1 Results: There was statistically highly significant difference (P<0.001) as regards serum visfatin between patients (mean 8.31±3.60, median 8, 64), and controls (mean 4.60±2.01), serum visfatin showed significantly higher levels in LN compared to the non-lupus nephritis group (mean 8.78±3.81 ng/ml,) versus (mean 7.85±3.38 ng/ml,). Also, visfatin level was significantly higher among the active (mean 9.30±3.14,) compared to the inactive group (mean 4.37±2.46). Visfatin had a highly significant positive correlation with SLEDAI, disease duration, corticosteroids treatment duration, ESR and CRP. Also, a significant inverse correlation existed between visfatin, WBCs and Platelets count, correlation studies between visfatin level and low level of C3, C4 were significant. The correlation between serum visfatin level and Carotid artery intima media thickness by carotid Doppler imaging was also significant. There was a significant decrease (P=0.041) between pretreatment visfatin level and post treatment level after 3 months of MMF and high dose CS treatment, Visfatin mean decreased from (8.78±3.81 ng/ml) to (8.29±3.44 ng/ml). Conclusion: visfatin is closely associated with SLE activity especially with lupus nephritis revealing the promising role of this adipokine in SLE activity measurement and prediction of renal involvement in SLE patients. Also, treatment regimen of combined mycophenolate mofetil (MMF) and corticosteroids is effective in decreasing visfatin level in Lupus nephritis patients as well as SLE activity, thus it helps in achieving disease remission.