Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease.
OBJECTIVE
Nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome are reaching epidemic levels worldwide, but data in Asia remain scarce. This cross-sectional study examined the metabolic and adipokine profiles of Chinese patients with biopsy-proven NAFLD and factors associated with severe disease.


METHODS
Eighty ethnic Chinese with NAFLD and 41 healthy controls were recruited. Metabolic parameters and fasting adiponectin, tumor necrosis factor-alpha (TNF-alpha), leptin, and resistin levels were measured on the day of liver biopsy. Histology was scored according to Brunt's criteria. Metabolic syndrome was assessed by using both the International Diabetes Federation and Adult Treatment Panel III criteria.


RESULTS
Twenty-eight patients had simple steatosis, and 52 patients had nonalcoholic steatohepatitis (NASH), defined as necroinflammatory grade >/=2 and/or fibrosis by Brunt's criteria. The ethnic-specific International Diabetes Federation criteria identified more cases of metabolic syndrome among NAFLD patients than the Adult Treatment Panel III criteria (70% vs 56%, P < .0001). On multivariate analysis, low adiponectin level, increased leptin level, and diabetes mellitus were associated with NAFLD. High TNF-alpha level and high body mass index were independent factors associated with NASH. TNF-alpha level had positive correlation with necroinflammatory grade (R = .35, P = .002) and fibrosis stage (R = .31, P = .005).


CONCLUSIONS
Hypoadiponectinemia and elevated TNF-alpha levels are associated with the development of NAFLD and NASH, respectively, independent of other metabolic factors. Ethnic-specific definition of metabolic syndrome is more useful in the assessment of NAFLD patients.
Wong
Vincent Wai-Sun
VW
Institute of Digestive Diseases, Chinese University of Hong Kong, Hong Kong SAR, China.
Hui
Alex Yui
AY
Tsang
Steven Woon-Choy
SW
Chan
Joyce Lai-Yee
JL
Tse
Ada Mei-Ling
AM
Chan
Kui-Fat
KF
So
Wing-Yee
WY
Cheng
Angela Yuen-Shan
AY
Ng
Wing-Fung
WF
Wong
Grace Lai-Hung
GL
Sung
Joseph Jao-Yiu
JJ
Chan
Henry Lik-Yuen
HL
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D044466:Asian People; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood* / Q000208:ethnology* / Q000473:pathology; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D036361:Peptide Hormones / Q000097:blood; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D052242:Adiponectin; D036361:Peptide Hormones; D014409:Tumor Necrosis Factor-alpha