Background Apelin is an adipokine that its level is increased by some proinflammatory cytokine such as TNF-alpha in metabolic, autoimmune and inflammatory conditions (1). Fetuin-A is protein secreted by liver, kidney, bone, brain, lungs and cardiovascular system (2). The levels of fetuin-a are decreased in some rheumatic diseases (ie. Rheumatoid arthritis, osteoarthritis). It has been suggested that fetuin-a can be a novel inflammatory biomarker in familial Mediterranean fever (FMF) (3).

Objectives To evaluate of the serum Apelin, Fetuin-A levels in patients with FMF during attack-free period (AFP) and to compare with healthy subjects.

Methods Thirty-FMF patients with AFP and thirty healthy subjects were included this study. The erythrocyte sedimentation rate (ESR), CRP, fibrinogen, hemogram, Mediterranean fever (MEFV) gene profiles, BMI, insulin, HOMA-IR, lipid profiles, serum apelin, fetuin-a levels were investigated.

Results Of the FMF patients and control, 20 (66.7%) was female and 10 (33.3%) was male. The distribution of MEFV gene mutation frequencies in the FMF patients was no mutation in 4 (13.3%) patients, M694V heterozygous in 7 (23.3%), M694V homozygous in 3 (10%), E148Q heterozygous in 5 (16.7%), M680I heterozygous in 2 (6.7%), M680I homozygous in 1 (3.3%), V726A in 2 (6.7%) and compound heterozygous mutation in 6 (20%). The median levels of apelin were 307.82±52.76 ng/mL in healthy subjects and 113,07±15,9 ng/mL in FMF (p=0.002) (Figure 1). The median levels of fetuin-a were 843,82±137.66 ng/mL in control group and 1352.2±127.61 ng/mL in FMF group (p=0.009) (Figure 1).

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Conclusions The lower serum apelin and higher fetuin-a levels in FMF patients with AFP than in healthy subjects were observed. It may be suggested that subclinical vascular inflammation is continued during attack-free period in patients with FMF.

1. Andrade-Oliveira V, Camara NO, Moraes-Vieira PM. Adipokines as drug targets in diabetes and underlying disturbances. J Diabetes Res 2015;2015:681612. doi: 10.1155/2015/681612. Epub 2015 Apr 8.

2. Xiao J, Wang XR, Hu KZ, et al. Serum fetuin-A levels are inversely associated with clinical severity in patients with primary knee osteoarthritis. Biomarkers 2013 Feb;18(1):51–4. doi: 10.3109/1354750X.2012.730551. Epub 2012 Oct 16.

3. Oncu K, Yazgan Y, Tanoglu A, et al. Can serum fetuin-A be regarded as an inflammatory marker among patients with familial Mediterranean fever? Dig Dis Sci 2013 Nov;58(11):3212–7. doi: 10.1007/s10620-013-2814-7. Epub 2013 Aug 8.

Acknowledgement We would like to thank to Ahmet Altun, M.D. for his statistical analysis.

Disclosure of Interest None declared