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Serum adipokine levels predictive of liver injury in non‐alcoholic fatty liver disease
Author(s) -
Lemoine Maud,
Ratziu Vlad,
Kim Minji,
Maachi Mustapha,
Wendum Dominique,
Paye François,
Bastard Jean Philippe,
Poupon Raoul,
Housset Chantal,
Capeau Jacqueline,
Serfaty Lawrence
Publication year - 2009
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2009.02022.x
Subject(s) - adipokine , fatty liver , alcoholic liver disease , medicine , liver injury , gastroenterology , disease , alcoholic fatty liver , obesity , leptin , cirrhosis
Aims: The aim of this study was to determine whether serum levels of adipokines, including the ratio of serum adiponectin to leptin (A/L) levels could predict the severity of liver injury in patients with non‐alcoholic fatty liver disease (NAFLD). Patients and methods: Fifty‐seven patients with biopsy‐proven non‐alcoholic steatohepatitis (NASH) (mean age 51±12, sex ratio 1), 17 with simple steatosis (mean age 47±12, sex ratio 1.4) and 10 controls without steatosis (mean age 51±11, sex ratio 4) were investigated. In all subjects, serum concentrations of triglycerides, ultrasensitive C reactive protein, leptin, adiponectin, soluble tumour necrosis factor receptor 1, interleukin (IL)‐6 and Homeostasis Model Assessment Method (HOMA) were measured. Hepatic expression of adiponectin and its two receptors was assessed by quantitative reverse transcriptase polymerase chain reaction. Results: Body mass index (BMI) and HOMA were correlated positively with leptin levels ( r =0.44 and 0.28 respectively) and negatively with the A/L ratio ( r =0.51 and 0.41 respectively). Independent parameters associated with NASH vs steatosis were HOMA>3 [odds ratio (OR)=6.9] and A/L ratio <1.4 10 3 (OR=5.2). The combination of HOMA with A/L ratio showed an area under the receiver operating characteristic curve of 0.82 for distinguishing between NASH and steatosis. Extensive portal fibrosis was present in 17 (23%) patients with NAFLD. Three independent parameters were associated with fibrosis: age (OR=1.1), BMI (OR=1.3) and high IL‐6 levels (OR=1.6). The hepatic expression of adiponectin receptor 2 was significantly higher in patients with NASH compared with controls and was related with necroinflammatory injury. Conclusions: This study shows that in patients with NAFLD, the combination of HOMA with A/L ratio may be a useful non‐invasive approach to appreciate the severity of liver damage.