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P074 Circulating adipokynes and Paraoxonase-1 activity in overweight Crohn's disease patients

K. Palatka*1, Z. Veréb2, L. Dávida1, P. Koncsos3, I. Seres3, G. Paragh3

1University Of Debrecen, Institute Of Internal Medicine, Department Of Gastroenterology, Debrecen, Hungary, 2University Of Szeged, Faculty Of Medicine, Department Of Ophthalmology, Stem Cells And Eye Research Laboratory, Szeged, Hungary, 3University Of Debrecen, Institute Of Internal Medicine, First Department Of Internal Medicine, Debrecen, Hungary

Background

Inflammatory bowel diseases (IBD) and especially Crohn's disease (CD) are associated with low BMI (body mass index). Although obesity was considered unusual a growing percentage of over weighted IBD patients could be observed, encountering a group with special characteristics Adipose tissue specially characterizing this population by the secretion of different adypocytokines could have an active role in inflammatory changes. Close relationship between PON1 and metabolic markers rise the possibility of the association of PON1 with nutritional status.

Aim of this study was to investigate the possible relationship between adipocitokynes leptin and adiponectin and PON1 activity in CD patients related to nutritional status, disease activity, treatment modalities, and different laboratory parameters.

Methods

Altogether 61 patient were recruited in the study. Groups were developed considering body mass index (BMI), biological therapy (untreated and treated with antiTNF-alfa infliximab respectively) and the status of Crohn's disease (active, inactive) as well.

Adiponectin and leptin concentrations of the sera were measured by sandwich enzyme immunoassays . PON1 paraoxonase activity was analyzed by kinetic semiautomated method, using salt-stimulated and arylesterase substrates. The dual substrate method was used to determine the phenotypic distribution of PON1, (ratio of salt-stimulated paraoxonase to the hydrolysis of phenyl acetate): ratio < 3.0 for AA, ratio between 3.0 and 7 for AB and ratio >7.0 for BB phenotype.

Results

Patients having active disease (CDAI>250) before biological treatment showed elevated leptin level which decreased during infliximab treatment in line with CDAI. (Median: 5.9111 vs. 4.7123, p=0.0236) Arylesterase activity rise in level during anti-TNF alpha treatment, restoring normal level. (Median 123.7441 vs. 106.2700, p=0.0185 respectively).No correlation regarding adiponectin level, paraoxonase activity and cholesterin fractions was found in biological treatment and untreated group. Positive correlation was detected between BMI and CDAI (r2=0.072001, p=0.058408), se LDL (r2=0.225477, p=0.006030) and leptin (r2=0.229931, p=0.005487) respectively. Significant differences were found in leptin levels when over weighted patients compared to the underweighted group (p=0.005487). No difference was observed to adiponectin (p=0.1086), aryl (p=0.6228) and PON (p=0.5527) respectively .

Conclusion

The link between inflammatory a metabolic processes seems to be more evident in owerweighted IBD patients. In this patient type inflammatory processe could be driven in different way needed new innovative therapeutic strategies. Further studies are required to elucidate the underlying immunopathogenesis.