Abstract: 【Abstract】 Objective To determine the expression of nucleobindin 2-encoded satiety and fat-influencing protein-1 （nesfatin-1） and interleukin （IL）-26 in the serum of patients with vitiligo, and to explore the relationship of nesfatin-1 and IL-26 with anxiety status, disease stage and distribution pattern of vitiligo lesions. Methods From March 2017 to September 2018, 123 outpatients with vitiligo, as well as 30 healthy controls （control group）, were enrolled from Department of Dermatology, Affiliated Hospital of Jiangsu University. Of these patients, 93 rated as anxious （vitiligo with anxiety group）, and 30 as non-anxious （vitiligo without anxiety group）. Another 30 anxious patients with other autoimmune diseases and background diseases like hypertension and diabetes mellitus but not vitiligo （anxiety group） were enrolled from Zhenjiang Fifth People′s Hospital. Enzyme-linked immunosorbent assay （ELISA） was performed to detect levels of nesfatin-1 and IL-26 in the above groups, and state-trait anxiety inventory （STAI） was used to evaluate the anxiety status. According to the vitiligo disease activity （VIDA） score, the vitiligo patients with anxiety were divided into 3 subgroups: stable stage group, active stage group and rapid progressive stage group. According to the distribution pattern of skin lesions, the vitiligo patients with anxiety were divided into 5 subgroups: localized vitiligo group, segmental vitiligo group, generalized vitiligo group, sporadic vitiligo group and acral vitiligo group. The levels of nesfatin-1 and IL-26 were compared among different stage groups and type groups. Statistical analysis was carried out using one-way analysis of variance for comparison among several groups, multi-way analysis of variance and stratification analysis for multifactor data, paired t-test for comparison before and after treatment, and Pearson correlation analysis for analyzing correlations. Results The serum level of nesfatin-1 significantly differed among the vitiligo with anxiety group, vitiligo without anxiety group, anxiety group and control group （F = 10.78, P < 0.001）, and was significantly higher in the vitiligo with anxiety group than in the other 3 groups （P < 0.001）. No significant difference in the serum level of IL-26 was found among the 4 above groups （F = 1.34, P = 0.26）. As pearson correlation analysis showed, the serum level of nesfatin-1 was positively correlated with the STAI score in the 93 vitiligo patients with anxiety （r = 0.55, P < 0.001）. The serum level of nesfatin-1 was significantly higher in the rapid progressive stage group than in the stable stage group （P < 0.05）, while there was no significant difference in the IL-26 level among different stage groups （P > 0.05）. The generalized vitiligo patients with anxiety showed significantly increased serum level of nesfatin-1 compared with the localized vitiligo patients with anxiety （P < 0.001）. After 3-month treatment, the nesfatin-1 level in the 10 vitiligo patients with anxiety significantly decreased compared with that before the treatment （paired t = 4.40, P = 0.02）, but the STAI score did not change （P > 0.05）. Conclusion Nesfatin-1 as an emotion-influencing factor may participate in the occurrence of vitiligo, especially affect patients with rapid progressive vitiligo or generalized vitiligo, while IL-26 may be irrelevant to vitiligo.

Key words: Vitiligo, Anxiety, Interleukin?26, Nesfatin?1, Generalized vitiligo