Low serum desnutrin predicts insulin resistance in patients with vitiligo vulgaris

The study revealed that in patients with vitiligo vulgaris, the serum desnutrin was suppressed due to increased glucose and insulin serum levels, perhaps contributing to insulin resistance (IR) and hyperlipidemia. This implies that low serum desnutrin could be a biomarker for IR in patients with vitiligo vulgaris.

Vitiligo is a common depigmented skin disorder with characteristics of selective melanocyte destruction. There is great evidence that vitiligo not only affects the skin but also has several systemic presentations. It may also be associated with metabolic abnormalities like lipid abnormalities, all of which emphasise the systemic nature of this disease. It has been reported that melanocytes, specifically those present in the adipose tissues, can prevent metabolic syndrome through their ability to reduce oxidative damage and inflammation.

Desnutrin is a member of the family of proteins that can organise adipose tissue lipolysis. It is reduced by refeeding and temporarily activated by fasting. Patients with vitiligo vulgaris are more likely to increased glucose and insulin serum levels, which may suppress the serum desnutrin perhaps contributing to IR.

Therefore, Mohammed Abu El-Hamd, Sohag University, Sohag, Egypt, and colleagues aimed to evaluate serum desnutrin and its association with IR in vitiligo vulgaris patients in a cross-sectional case-control study.

The study included 45 patients with vitiligo vulgaris and 45 age- and sex-matched healthy controls. Patients underwent complete general and cutaneous evaluations.

All participants were subjected to the assay of cholesterol, fasting blood glucose (FBG), very low-density lipoprotein (VLDL), high-density lipoprotein (HDL), fasting serum insulin, low-density lipoprotein (LDL), and serum desnutrin. For all participants, Homeostasis Model Assessment + insulin resistance (HOMA + IR) was calculated.

The study led to the following findings:

• There were statistically significant differences between the patients with vitiligo vulgaris and healthy controls regarding FBG, HDL, HOMA-IR, fasting insulin, and serum desnutrin.
• Desnutrin levels were negatively correlated with FBS, LDL, VLDL, fasting insulin, and HOMA-IR.
• The level of desnutrin had a positive, non-significant correlation with HDL (rho = 0.17).

This study concluded that in vitiligo vulgaris patients, as a result of increased serum levels of glucose and insulin, the serum desnutrin was suppressed, perhaps contributing to insulin resistance and hyperlipidemia.

"There is a need for a multidisciplinary approach to the early detection of diabetes mellitus, hyperlipidemia, and IR among patients with vitiligo vulgaris to avoid metabolic and cardiovascular complications," the researchers concluded.

Reference:

El-Hamd, Mohammed Abu, et al. "Desnutrin as a Biomarker for Insulin Resistance in Patients With Vitiligo Vulgaris." Indian Journal of Dermatology, vol. 68, no. 4, 2023, pp. 366-371.