ADIPONECTIN, LEPTIN, RESISTIN LEVELS IN CYSTIC FIBROSIS ADOLESCENTS

Abstract

INTRODUCTION: Patients with Cystic Fibrosis, especially in adolescence, could develop endocrine and metabolic complications, related to nutritional state and chronic inflammation. They develop a progressive decrease in lean body mass correlated with the progression of lung disease. Adipose tissue is involved as well and adipocytokines are a possible link between malnutrition and long term complications. PATIENTS AND METHODS: In 24 Cystic Fibrosis adolescents we studied auxological, nutritional, glycometabolic, endocrine patterns, together with leptin, adiponectin and resistin levels. We selected patients not affected by diabetes, insulin resistance, malnutrition, acute inflammatory states so as to avoid possible influences on the adipocytokines. RESULTS: All patients presented with an adequate BMI centile, with no statistically significant difference versus controls. HOMA IR and HOMA B% are in the normal range but lower than in controls, expression of a lower insulin-resistance with a lower insulin secretion. Leptin is significantly higher than in controls and maintains a correlation with BMI and gender. Resistin levels are more elevated in Cystic Fibrosis than in controls, with a statistically significant direct correlation with CRP (C-reactive protein) and insulinemia T0’ and T120’.Adiponectin is significantly higher in Cystic Fibrosis, inversely correlated with CRP and insulinemia and directly with cholesterol and HDL-cholesterol. CONCLUSIONS:The detection of adipocytokines levels could improve the metabolic follow-up of these patients: the maintenance of an adequate leptin gender difference is useful in the follow-up of puberty in adolescence. Adiponectin could be a marker of insulin sensitivity and prevent protein catabolism and loss of lean body mass. Resistin levels may be used as a marker of insulin resistance and may indicate the severity of chronic inflammation. This is the first study available in literature about adiponectin levels in pediatric Cystic Fibrosis patients and about resistin in Cystic Fibrosis.