Plasma adiponectin levels in primary biliary cirrhosis: a novel perspective for link between hypercholesterolemia and protection against atherosclerosis.
BACKGROUND
Hypercholesterolemia is a common finding in primary biliary cirrhosis (PBC), but the risk of cardiovascular events in PBC patients is not increased in respect to the general population. High serum adiponectin levels appear to play a protective role in the development of either metabolic syndrome or cardiovascular disease.


OBJECTIVE
To investigate factors potentially preventing atherosclerosis in PBC patients.


METHODS
Circulating levels of adiponectin, resistin, leptin, and tumor necrosis factor-alpha (TNF-alpha) were measured in 137 consecutive PBC patients (125 women, 12 men; mean age 61.6 +/- 12.3 yr), 137 sex- and age-matched healthy controls, and 30 female patients with nonalcoholic steatohepatitis (NASH) and associated metabolic syndrome.


RESULTS
The body mass index (BMI) was comparable in the three groups, whereas total cholesterol was significantly higher in both PBC and NASH cases than in controls (221.6 +/- 50.5 mg/dL in PBC vs 221.7 +/- 39.7 mg/dL in NASH vs 209.8 +/- 39.2 mg/dL in controls, P < 0.05). Serum concentrations of adiponectin, resistin, and leptin were significantly higher in PBC patients than in either NASH cases or controls (P < 0.05). Among the PBC patients, only adiponectin correlated positively with histological progression of the disease (P= 0.001) and negatively with BMI (P= 0.01). Logistic regression analysis revealed that adiponectin correlated independently with age, BMI, Mayo score, and gamma-glutamyl transpeptidase.


CONCLUSIONS
The high adiponectin concentrations observed in PBC patients should be regarded as a possible protective factor against atherogenesis. The search for further protective factors should be encouraged.
Floreani
Annarosa
A
Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy.
Variola
A
A
Niro
G
G
Premoli
A
A
Baldo
V
V
Gambino
R
R
Musso
G
G
Cassader
M
M
Bo
S
S
Ferrara
F
F
Caroli
D
D
Rizzotto
E Rosa
ER
Durazzo
Marilena
M
D052242:Adiponectin / Q000097:blood*; D000368:Aged; D050197:Atherosclerosis / Q000517:prevention & control*; D016022:Case-Control Studies; D005234:Fatty Liver / Q000097:blood; D005260:Female; D006505:Hepatitis / Q000097:blood; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000150:complications; D008105:Liver Cirrhosis, Biliary / Q000097:blood* / Q000150:complications; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D052242:Adiponectin; D014409:Tumor Necrosis Factor-alpha