Serum lipid changes and insulin resistance in familial Mediterranean fever

Abstract

Objective: Inflammation is known to alter lipid profiles and to induce insulin resistance. This study was planned to test the hypothesis that familial Mediterranean ferver (FMF) patients and their first-degree asymptomatic relatives may have lipid profile changes and/or insulin resistance, similar to other inflammatory diseases. Material and Methods:We studied 72 FMF patients, 30 asymptomatic first-degree relatives, and 75 healthy controls. Fasting and 2-hour postprandial glucose, insulin, apolipoprotein (Apo) A1, Apo B, acute phase reactants, and lipid profiles of all subjects were studied. Insulin resistance was determined by the HOMA (Homeostasis Model Assessment) index.Results: There was no difference between the groups with regard to sex, mean systolic and diastolic blood pressure, body mass index, smoking status, fasting and postprandial 2-hour glucose, insulin, acute phase reactants, and HOMA index levels. High-density lipoprotein cholesterol (HDL-C) levels were similar between FMF patients and FMF relatives (48.9±12.4 mg/dL vs 49.3±13.8 mg/dL; p=NS), and both were lower than controls (48.9±12.4 mg/dL vs 59.6±15.1 mg/dL; p<0.001 and 49.3±13.8 mg/dL vs 59.8±15.1 mg/dL; p=0.001, respectively). Apo A1 levels in FMF patients and asymptomatic first-degree FMF relatives were both lower than in controls, similar to the HDL-C levels (126.1±25.7 mg/dL vs 151.2±31.4 mg/dL; p<0.001 and 129.5±29.0 mg/dL vs 151.2±31.4 mg/dL; p=0.002, respectively). TG levels were significantly higher in FMF relatives as compared to controls (113.4±53.6 mg/dL vs 97.1± 54.9 mg/dL; p=0.025).Conclusion: Low HDL-C and low Apo A1 levels are found in FMF patients and their first-degree asymptomatic relatives. Low-grade inflammation caused by MEFV mutations may be responsible for these lipid profile changes.

Vitamin D status, serum lipid concentrations, and vitamin D receptor (VDR) gene polymorphisms in Familial Mediterranean fever

“…In a study by Acay et al [14], lower HDL-C and higher triglyceride concentrations were reported in patients with FMF. Candan et al [15] found the difference only in HDL-C concentrations between FMF and control group. Another study showed that FMF patients had lower concentrations of total cholesterol and HDL-C compared to controls [38].…”

“…Moreover, different factors, such as serum lipid changes and endothelial dysfunction, were associated with cardiovascular events [13]. Recent studies showed that FMF patients have an increased risk for cardiovascular events compared with healthy controls, due to increased inflammation and altered serum lipid profile, but discordant results have also been reported on the serum lipid levels in FMF [14,15].…”

Ailevi Akdeniz Ateşi Hastalarında Pro-aterojenik Lipid Profili ve Aterojenik İndeksin Değerlendirilmesi / Assessment of Pro-atherogenic Lipid Profile and Atherogenic Index in Patients with Familial Mediterranean Fever

“…2014 yılında yayınlanan iki çalışmada FMF hastalarında sağlıklı kontrollere göre HDL düzeylerinin anlamlı oranda daha düşük olduğu tespit edilse de diğer küçük örneklem büyüklüğüne sahip çalışmalarda FMF hastalarını ile sağlıklı kontroller arasında lipid profilleri bakımından fark bulunamamıştır. 1,[19][20][21] 2022 yılında yayınlanan 164 FMF hastası ve 160 sağlıklı kontrolün dahil edildiği başka bir çalışmada ise TK, TG ve LDL seviyelerinin FMF grubunda anlamlı oranda daha yüksek olduğu tespit edilmiş fakat HDL düzeyleri iki grupta da benzer bulunmuştur. 22 Çalışmamızda TK ve LDL düzeylerinin beklenenin aksine sağlıklı grupta FMF grubuna göre istatistiksel olarak anlamda oranda daha yüksek olduğu tespit edilirken, TG ve HDL düzeyleri açısından iki grup arasında fark bulunamadı.…”