Circulating ghrelin and apelin levels in nonobese psoriasis vulgaris patients

Background The metabolism and immune system are linked via a network of many mediators known as adipokines. Ghrelin and apelin-36 are unique adipokines; however, their role in psoriasis, an immune-mediated disease, remains unclear. Objective To detect the serum levels of ghrelin and apelin-36 in psoriasis vulgaris patients in comparison with controls and to correlate their levels with severity of psoriasis, BMI, lipid profile, and glycated hemoglobin (HbA1c). Patients and methods The present case–control study included 70 nonobese psoriasis vulgaris patients and 70 controls. The severity of psoriasis was assessed using the psoriasis area and severity index score. The ghrelin and apelin-36 serum levels, cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and HbA1c were measured. Results Psoriatic patients had significantly higher ghrelin (P<0.001), HbA1c (P<0.001), cholesterol (P<0.001), triglycerides (P<0.001), and low-density lipoprotein (P=0.001) levels and a lower apelin-36 (P<0.001) serum level than controls. Serum ghrelin was negatively correlated with psoriasis area and severity index score (r=−0.75; P<0.001), whereas serum apelin-36 was negatively correlated with HbA1c mean values (r=−0.44; P=0.004) and was found to be a good predictor of prediabetes in psoriatic patients (P=0.012). Nonsignificant correlation between ghrelin and apelin-36 serum levels was observed in psoriatic patients. Conclusion Ghrelin and apelin-36 are dynamic adipokines that might play a role in psoriasis vulgaris pathogenesis. The role of ghrelin and apelin-36 in psoriasis might be mediated through dyslipidemia and impaired glucose metabolism in psoriatic patients, respectively. Targeting both ghrelin and apelin-36 may be of value in management of metabolic syndrome associated with psoriasis. Serum apelin-36 assessment can predict prediabetic state in psoriatic patients.