title: Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease.
abstract: 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.
authors.affiliation: Institute of Digestive Diseases, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Vincent Wai-Sun
authors.initials: VW
authors.lastname: Wong
authors.forename: Alex Yui
authors.initials: AY
authors.lastname: Hui
authors.forename: Steven Woon-Choy
authors.initials: SW
authors.lastname: Tsang
authors.forename: Joyce Lai-Yee
authors.initials: JL
authors.lastname: Chan
authors.forename: Ada Mei-Ling
authors.initials: AM
authors.lastname: Tse
authors.forename: Kui-Fat
authors.initials: KF
authors.lastname: Chan
authors.forename: Wing-Yee
authors.initials: WY
authors.lastname: So
authors.forename: Angela Yuen-Shan
authors.initials: AY
authors.lastname: Cheng
authors.forename: Wing-Fung
authors.initials: WF
authors.lastname: Ng
authors.forename: Grace Lai-Hung
authors.initials: GL
authors.lastname: Wong
authors.forename: Joseph Jao-Yiu
authors.initials: JJ
authors.lastname: Sung
authors.forename: Henry Lik-Yuen
authors.initials: HL
authors.lastname: Chan
mesh_terms: 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
chemical_list: D052242:Adiponectin; D036361:Peptide Hormones; D014409:Tumor Necrosis Factor-alpha