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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 79 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) Summary 80 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). |