Serum adipokine levels predictive of liver injury in non-alcoholic fatty liver disease.
OBJECTIVE
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).


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.
Faculté de Médecine, Universite Pierre et Marie Curie, Paris, France.
Maud
M
Lemoine
Vlad
V
Ratziu
Minji
M
Kim
Mustapha
M
Maachi
Dominique
D
Wendum
François
F
Paye
Jean Philippe
JP
Bastard
Raoul
R
Poupon
Chantal
C
Housset
Jacqueline
J
Capeau
Lawrence
L
Serfaty
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D005234:Fatty Liver / Q000097:blood* / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis; D054419:Receptors, Adiponectin / Q000235:genetics
C475418:ADIPOR1 protein, human; C475420:ADIPOR2 protein, human; D052242:Adiponectin; D015850:Interleukin-6; D020738:Leptin; D012333:RNA, Messenger; D054419:Receptors, Adiponectin