ISSN 2149-2247 | E-ISSN 2149-2549
Original Article
Nail Fold Capillary Abnormality and Insulin Resistance in Children with Familial Mediterranean Fever: Is There Any Relationship Between Vascular Changes and Insulin Resistance?
1 Department of Pediatric Nephrology, Erciyes University Faculty of Medicine, Kayseri, Turkey  
2 Department of Dermatology, Erciyes University Faculty of Medicine, Kayseri, Turkey  
3 Department of Electronics Engineering, Erciyes University Faculty of Engineering, Kayseri  
4 Department of Biochemistry, Erciyes University Faculty of Medicine, Kayseri, Turkey  
Erciyes Med J 2018; 40: 70-74
DOI: 10.5152/etd.2018.0015
Key Words: Familial mediterranean fever, nail fold capillary abnormality, insulin resistance


Objective: Nail fold capillary changes are accepted as early symptoms of several rheumatic disorders such as scleroderma and dermatomyositis. In adults, nail fold capillary abnormality (NCA) has been described in Familial Mediterranean Fever (FMF). However, there is not enough study in children with FMF. The aim of the present study was (1) to investigate whether children with FMF have NCA in both active and/or remission period or not and (2) to assess insulin resistance in children with FMF in both active and/or remission period of the disease compared with the control group.

Materials and Methods:
Ninety-two patients with FMF, including 25 patients in the active period and 67 patients in the remission period, and 33 apparently healthy children were enrolled in the study. Nail fold capillary examination was performed. Groups were compared for inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A (SAA)), insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR), and NCA. The relationship among the NCA, insulin resistance, and inflammatory markers was evaluated.

Results: Overt NCA was found in 20% of patients at the attack period and in 2.9% of patients in remission. HOMA-IR was higher at the attack period than at the attack-free period and control. However, this did not reach statistical significance. Nevertheless, HOMA-IR was positively correlated with SAA. The NCA was significantly positively correlated with increased levels of acute-phase reactants and was significantly negatively correlated with serum high-density lipoprotein levels.

Conclusion: There are apparent NCA in children with FMF especially in the active period of the disease. There is insulin resistance that is likely associated with inflammation. The NCA becomes overt in the active period of the disease as insulin resistance.

Cite this article as: Dursun İ, Tulpar S, Yel S, Kartal D, Borlu M, Baştuğ F, et al. Nail fold capillary abnormality and insulin resistance in children with familial Mediterranean fever: is there any relationship between vascular changes and insulin resistance? Erciyes Med J 2018; 40(2): 70-4

Key Words
Author’s Corner
AVES | Copyright © 2018 Erciyes University Faculty of Medicine | Latest Update: 03.10.2018