الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Vitiligo is a cutaneous hypomelanosis, accompanied by
melanocytes loss, with a worldwide prevalence of 1–4%. It is
characterized by loss of functioning epidermal melanocytes. In almost
half of the patients, vitiligo starts before the age of 20 years however it
can be seen at any age group with no significant sex difference.
Although several theories have been proposed about the pathogenesis
of vitiligo, the precise cause remains unknown. Generally agreed upon
principles are an absence of functional melanocytes in vitiligo skin
and a loss of histochemically recognized melanocytes, owing to their
destruction. However, the destruction is most likely a slow process
resulting in a progressive decrease of melanocytes. Autoimmunity and
oxidative stress are two important mechanisms which are responsible
for its aetiopathogenesis.
Fatty acid-binding protein 4, also known as A-FABP, plays an
important role in the development of insulin resistance and
atherosclerosis in relation to metaflammation. It serves as a lipid
chaperone that regulates transport, metabolism and storage of lipids. It
has a role in cytoprotection against oxidative stress and able to
dismutate superoxide, which is the primary ROS generated during
oxygen metabolism. It is mainly expressed in differentiated adipocytes
and macrophages, and previous studies have focused on its association
with MetS and its related components, especially obesity.
Metabolic syndrome is a condition in which mainly insulin
resistance is developed and ultimately leads to cardiovascular
complications. Approximately 25% of the world’s population is
affected by MetS, with a significant subpopulation linked to
inflammatory skin diseases. It is documented that oxidative stress is
Summary
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one of the main reasons for the pathogenesis of MetS, possible related
with vitiligo.
The aim of this study was to evaluate the serum level of FABP4
in vitiligo patients and its relation to MetS.
This study was conducted on 45 patients having NSV. In
addition to 45 age and sex matched healthy subjects were included in
this study as a control group. For all participants, history taking and
clinical examination including VASI score assessment were
performed. Also, lipid profile, fasting and PPS, and serum FABP4
levels were measured.
The results of the current study showed that:
The BMI was significantly higher in patients than control (29
vs 24) (p<0.001).
There were significant higher mean levels of cholesterol (207.16
± 64.51 vs 171.36 ± 38.05) and TG (143.84 ± 55.80 vs 117.44 ±
27.44) in vitiligo patients than control (p<0.001and p= 0.005
respectively).
The MetS was significantly more prevalent among our studies
vitiligo patients than the control group (p<0.001).
There was a significant elevation of FABP4 serum level in
patients (46.78±14.54) than control (27.67±7.65).
There was a significant positive correlation between FABP4
levels and BMI in the control group (r=0.66; p<0.001).
In vitiligo patients, there were significant positive correlations of
FABP4 serum levels with TG, cholesterol and LDL levels
[(r=0.39; p=0.047) (r=0.83; p˂0.001) (r=0.66; p˂0.001)
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respectively] and a significant negative correlation regarding
HDL level (r=-0.39; p= 0.009).
In vitiligo patients, there was a significant association between
high FABP4 levels and presence of MetS in the studied vitiligo
patients.
Receiver operating charcterstic curve showed that FABP4 level
was a significant good diagnostic test for early detection of
vitiligo with best cut off point equals 33.0 ng/ml, senitivty of
82%, specificity of 76% and 0.863 area under the curve
(p<0.001).