leptin and Mucocutaneous-Lymph-Node-Syndrome

Adipokines are cytokines derived from adipose tissue. Recently it has been established that adipokines are closely linked to the pathophysiology of not only metabolic diseases, such as diabetes mellitus, obesity, and atherosclerosis, but also to inflammation and immune diseases. In this study we measured serum levels of adipokines in patients with acute Kawasaki disease to investigate the role of adipokines in the pathophysiology of Kawasaki disease. Serum resistin, high-molecular-weight (HMW) adiponectin, leptin, and visfatin levels were measured by enzyme-linked immunosorbent assay in a total of 117 subjects: 56 patients with acute Kawasaki disease, 30 healthy children, and 31 patients with acute infectious diseases. Serum resistin levels in patients with Kawasaki disease were significantly higher than those of healthy children and patients with acute infectious diseases. In contrast, mean serum HMW adiponectin, leptin, and visfatin levels in patients with Kawasaki disease exhibited no statistically significant differences compared with those in healthy children and patients with infectious diseases. Serum resistin levels decreased significantly after administration of intravenous immune globulin. Serum resistin levels on admission were significantly higher in nonresponders compared with responders to intravenous immune globulin therapy. A multivariate model revealed that C-reactive protein was a factor that was significantly related to elevated serum resistin level in patients with Kawasaki disease. In patients with Kawasaki disease, serum resistin levels were elevated, but decreased to nearly normal after intravenous administration of immune globulin. In contrast, serum HMW adiponectin, leptin, and visfatin levels showed no statistically significant changes. These findings suggest that resistin plays an important role, while other adipokines do not play a major role, in the pathogenesis of Kawasaki disease.

Topics: Adipokines; Adiponectin; C-Reactive Protein; Child, Preschool; Communicable Diseases; Female; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Leptin; Male; Molecular Weight; Mucocutaneous Lymph Node Syndrome; Nicotinamide Phosphoribosyltransferase; Resistin

Body fat is an important source of adipokines not only in association with energy balance, but also with inflammatory and immune responses. This study investigated the relationship between serum levels of adipokines and coronary artery aneurysm in patients with Kawasaki disease (KD). Levels of leptin, adiponectin, and resistin were measured in 165 cases, including 4 groups: the control group (n = 85), KD with normal coronary arteries (n = 41), KD with dilatation and/or ectasia (n = 31), and KD with coronary aneurysm (n = 8). White blood cells counts (WBC), red blood cells counts (RBC), hemoglobin (HB), Hematocrit (Hct), platelet count, C reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were tested in children. Levels of adiponectin and resistin levels were significantly elevated; hemoglobin significantly decreased in the group of KD with coronary aneurysm compared with the controls or other KD subgroups. There were markedly positive relationships between levels of resistin and CRP, and negative relationships between levels of resistin and RBC in patients with KD. Levels of adiponectin, resistin, and hemoglobin were associated with the development of coronary aneurysm in children with KD. The up-regulation of resistin secreted from adipose tissue may be closely linked to up-regulation of systemic proinflammatory markers in acute KD.

Topics: Adiponectin; Adipose Tissue; Child, Preschool; Coronary Artery Disease; Female; Hematocrit; Hemoglobins; Humans; Infant; Leptin; Leukocyte Count; Male; Mucocutaneous Lymph Node Syndrome; Platelet Count; Predictive Value of Tests; Resistin; Vasculitis