journal reading : Obesity and Cytokines in Childhood – Onset Systemic Lupus Erythematosus

8/10/2019 journal reading : Obesity and Cytokines in Childhood Onset Systemic Lupus Erythematosus

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Denata Prabhasiwi,S.ked (030.09.062)


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atherosclerosis is attributed to traditional and lupus related risk factors

including metabolic syndrome (MetS), obesity, and inflammation.

background

to evaluate the association between obesity, measures of body fatcontent, serum tumor necrosis factor alpha (TNF-), and interleukin (IL)-

6 and -10 levels in childhood-onset SL (cSLE).

objective

We screened consecutive cSLE patients followed up in the PediatricRheumatology Outpatient Clinic of the State University of Campinas.cSLE patients were assessed for disease and damage. Obesity wasdefinite as body mass index (BMI) 30 kg/m2. Serum TNF-, IL-6, and IL-10 levels were measured by ELISA. Dual-energy X-ray absorptiometrywas use to determine total fat mass, lean mass, and percent of body fat.

Methods


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We included 52 cSLE patients and 52 controls. cSLE patientshad higher serum TNF-(= 0.004), IL-6 (= 0.002), andIL-10 (< 0.001) levels compared to controls. We observedhigher serum TNF-(= 0.036) levels in cSLE patients withobesity. An association between serum TNF-levels and

body fat percent (= 0.046) and total fat mass on trunkregion (= 0.035) was observed.

Result

serumTNF-levels were associated with obesity and bodyfat content in cSLE. Our finding suggests that obesity maycontribute to the increase of serum TNF-levels in cSLE.

Conclusion


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Introduction

chronic systemic

inflammatory

disease affecting

mainly women

during

childbearing

age

linked to the

increased risk of

CVD


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Introduction

Obesity-associated systemic inflammation is

characterized by increased circulatingproinflammatory cytokines and activation of

several kinases that regulate inflammation


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ADIPOSETISSUE

IL 6

TNF-IL 10

Introduction


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Patients and methods

subject

Fifty-two consecutive cSLE patients, recruited from the Pediatric RheumatologyOutpatient Clinic of the State University of Campinas

fulfilled at least four criteria of the American College of Rheumatology (ACR)

Below 18 years of age at disease onset

Had a follow up duration at least 6 months

Clinicalfeatures

Total doses and length of use the of corticosteroids


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Diseaseactivity

Disease activity was measured by the Systemic Lupus ErythematosusDisease Activity Index (SLEDAI). SLEDAI scores range between 0 and 105,and the scores of 3 were considered asactive disease .

Cumulative SLE-related damage in all patients was determined by usingthe Systemic Lupus International Collaborating Clinics (SLICC)/ACR DamageIndex (SDI)

Body MassIndex

Obesity was considered when BMI was above 30 Kg/m2.



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Dual X RayAbsorptiometry

Percentual body fat (PBF), fat mass, and lean mass were obtained by DXA scan

Blood Sampling

Blood samples were collected from peripheral veins of all individuals in drytubes and left to clot at room temperature for 30minutes.

Blood samples were then centrifuged for 15 minutes at 3000 rpm, and theserum was then stored in aliquots at 80C for future use.

We did not collect blood samples from individuals during an episode of acute orchronic infection.



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CytokinesAssay

Commercially available kits from R&D Systems (London, UK) were used forthe measurement of serum TNF-, IL-6, and IL-10 levels by enzymelinkedimmunosorbent assay (ELISA), carried out in accordance with themanufacturers instructions.

The minimum detectable dose (MDD) was 0.106 pg/mL for TNF-,0.039pg/mL for IL-6, and 3.9 pg/mL for IL-10.

StatisticalAnalysis

For all analyses, value 0.05 wasconsidered to be statisticallysignificant.

Statistical analysis was carried out using IBM SPSS Statistics 16.0 software

(SPSS/IBM, Chicago, IL, USA).



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Whole body (median) Trunk region (median)

fat mass : 22,38 kg

(range : 7,67 kg36,62 kg)

Fat mass :8,62 kg

(range : 2,98 kg17,59 kg)

Lean mass : 35,49 kg

(range : 25,31 kg52,14 kg)

Lean mass : 16,80 kg

(range: 11,24 kg26,19 kg)

PBF : 34,1 %

(range : 12,154,4%)

PBF : 42,3%

(nge : 12,154,4%)

Association between TNF-and PBF ( = 0.046) and total fat mass on

trunk region ( = 0.035) analyzed by DXAscans.


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obese cSLE patients had

higher serum TNF- levels

when compared to

nonobese cSLE and healthycontrols


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ADIPOSE

TISSUE

CHRONIC

INFLAMMATION


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TNF-

Promote initial atheromeplaque

Reduction in lipoproteinlipase activity

Regulating adipocyte size inthe face of increasing energyconsumption

IL 6Metabolic dysfunction

CRP


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serumTNF-levels were associated

with obesity and body fat content in

cSLE. Our finding suggests that obesity

may contribute to the increase of

serum TNF-levels in cSLE


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cSLE obeseTNF-

increased

risk of CVD


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journal reading : Obesity and Cytokines in Childhood – Onset Systemic Lupus Erythematosus

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