The Relationship Among the Level of Serum Amyloid A, High-Density Lipoprotein and Microalbuminuria in Patients With Familial Mediterranean Fever.
BACKGROUND
Serum amyloid A (SAA), which is produced in the liver, acts as an apoprotein of high-density lipoprotein (HDL) accumulation in extracellular matrix of tissues and organs. SAA elevations play a significant role in the development of amyloidosis. Microalbuminuria (MAU) is the early period of amyloidosis in patients with familial Mediterranean fever (FMF). We assessed the association between SAA as an important factor for the development of amyloidosis in patients with FMF and cytokines, HDL, and MAU.


METHODS
A total of 40 FMF patients diagnosed with Tel-Hashomer criteria and making regular follow-up visits at the tertiary referral center from 2012 to 2013 were included in this study, besides 40 age- and sex-matched individuals as controls.


RESULTS
Compared with controls, FMF patients had higher SAA (25.20 ± 45.78 vs. 1.68 ± 0.63 ng/ml; P = 0.002). Also, FMF patients had higher MAU than controls (23.20 ± 39.86 vs. 9.40 ± 5.32 mg/day; P = 0.036). HDL was significantly lower in the patient group than in controls (39.35 ± 10.45 vs. 47.82 ± 15.31 mg/dl; P = 0.023). Interleukin-1 beta (IL-1), IL-6, and tumor necrosis factor alpha (TNF-α) levels were higher in the FMF group than in controls (P < 0.0001, P = 0.009, P = 0.003, respectively).


CONCLUSIONS
Our results suggest that IL-1, IL-6, TNF-α, SAA, and HDL may serve as markers of subclinical inflammation in FMF patients. Due to increased plasma HDL levels, antiinflammatory and antioxidant effects may elevate in FMF patients.
Department of Internal Medicine, Eskisehir Military Hospital, Eskisehir, Turkey. drauuslu@gmail.com.
Ali Ugur
AU
Uslu
Department of Internal Medicine, Etimesgut Military Hospital, Ankara, Turkey.
Bahattin
B
Aydin
Department of Internal Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Ibrahim Serhat
IS
Icagasıoğlu
Department of Cardiology, Gulhane Medical Faculty, Ankara, Turkey.
Sevket
S
Balta
Department of Internal Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Köksal
K
Deveci
Department of Internal Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Filiz
F
Alkan
Department of Nephrology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Gürsel
G
Yıldız
Department of Rheumatology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Ali
A
Sahin
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D016207:Cytokines / Q000097:blood; D010505:Familial Mediterranean Fever / Q000097:blood* / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D012372:ROC Curve; D012189:Retrospective Studies; D000685:Serum Amyloid A Protein / Q000378:metabolism*; D055815:Young Adult
D016207:Cytokines; D008075:Lipoproteins, HDL; D000685:Serum Amyloid A Protein
familial Mediterranean fever; high-density lipoprotein; inflammation; microalbuminuria; serum amyloid A