c-peptide and Vitiligo

Autoimmune diseases, including autoimmune endocrine diseases (AIED), are thought to develop following environmental exposure in patients with genetic predisposition. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and vaccines against it could represent new environmental triggers for AIED. We report a patient, with history of vitiligo vulgaris and 8 years of type 2 diabetes, who came to our institution because of fever, weight loss, asthenia and thyrotoxicosis occurred 4 weeks later the administration of BNT162B2 (Pfizer-BioNTech) SARS-CoV-2 vaccine. Clinical, biochemical and instrumental work-up demonstrated Graves' disease and autoimmune diabetes mellitus. The occurrence of these disorders could be explained through different mechanism such as autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome), mRNA "self-adjuvant" effect, molecular mimicry between human and viral proteins and immune disruption from external stimuli. However further studies are needed to better understand the underlying pathogenesis of AIED following SARS-CoV-2 vaccine.

Topics: Adjuvants, Immunologic; Autoantibodies; BNT162 Vaccine; C-Peptide; COVID-19; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Glycemic Control; Graves Disease; Humans; Male; Middle Aged; Molecular Mimicry; SARS-CoV-2; Thyrotoxicosis; Vitiligo

The aim of this study was to evaluate the relationship between vitiligo and insulin resistance (IR). A total of 96 subjects were included in the study; 57 patients with vitiligo and 39 subjects in an age and a body mass index-matched control group. In fasting blood samples, insulin, C-peptide, glucose, total cholesterol, triglyceride, low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) were measured. IR was calculated with the homeostasis model assessment-IR (HOMA-IR) method. Comparison of the vitiligo and the control groups revealed that patients with vitiligo had higher IR (2.3 vs. 2.0, p < 0.01), higher insulin and C-peptide levels (p < 0.001, p < 0.001, respectively), higher LDL/HDL ratio and lower HDL-C levels (p < 0.01, p < 0.0001, respectively). Systolic blood pressures of patients with vitiligo were also higher compared with control subjects (p < 0.01). Further experimental and clinical studies are needed to elucidate the molecular mechanisms underlying this association.

Topics: Adult; Biomarkers; Blood Glucose; Blood Pressure; Body Mass Index; C-Peptide; Case-Control Studies; Chi-Square Distribution; Fasting; Female; Humans; Insulin; Insulin Resistance; Lipids; Male; Middle Aged; Turkey; Vitiligo; Waist Circumference; Young Adult

Topics: Autoantibodies; C-Peptide; Case-Control Studies; Child; Diabetes Complications; Diabetes Mellitus; Glucose Intolerance; Humans; Oman; Vitiligo