title: Adipokine serum levels are related to liver histology in severely obese patients undergoing bariatric surgery.
abstract: BACKGROUND
  Leptin, adiponectin, and resistin are adipokines linked to the development of insulin resistance, which plays a central role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). We aimed to define adipokine serum levels in severely obese patients undergoing bariatric surgery and to correlate these with anthropometric and metabolic variables, liver function tests, and histopathological parameters of NAFLD and nonalcoholic steatohepatitis (NASH).
  
  
  METHODS
  Surgical liver biopsies were obtained from 50 bariatric patients with no history of liver disease or significant alcohol consumption. Serum leptin, adiponectin, and resistin levels were measured, and histology was assessed using Brunt's and Kleiner's scoring systems.
  
  
  RESULTS
  Waist/hip ratio was significantly higher in men (p = 0.0001), and leptin (p = 0.036) and adiponectin (p = 0.0001) serum levels were higher in women. Forty-one of 50 patients (82%) had histological NAFLD, including 10 (20%) with NASH. Nine patients (18%) had normal liver histology (obese control subgroup). In NAFLD patients, serum adiponectin was negatively correlated with activity grade and fibrosis stage, resistin was negatively correlated with steatosis grade (p = 0.033), while leptin was not related to histology. Leptin/adiponectin ratio showed positive association with stage (p = 0.044). In the subgroup of NASH patients, adiponectin was negatively correlated only with stage (p = 0.01), while there was no correlation between leptin, resistin, or leptin/adiponectin and histology.
  
  
  CONCLUSIONS
  Serum adiponectin and resistin levels are related to liver histology in bariatric patients and may be indicative of the histological severity of NAFLD and the extent of hepatic steatosis, respectively. Serum leptin levels are not informative of underlying liver histology in severely obese patients.
authors.affiliation: Department of Surgery-Division of Nutritional Support and Morbid Obesity, Medical School, University of Patras, Patras, Greece.
authors.forename: Marianna
authors.initials: M
authors.lastname: Argentou
authors.forename: Dina G
authors.initials: DG
authors.lastname: Tiniakos
authors.forename: Menelaos
authors.initials: M
authors.lastname: Karanikolas
authors.forename: Maria
authors.initials: M
authors.lastname: Melachrinou
authors.forename: Maria G
authors.initials: MG
authors.lastname: Makri
authors.forename: Christos
authors.initials: C
authors.lastname: Kittas
authors.forename: Fotis
authors.initials: F
authors.lastname: Kalfarentzos
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D015904:Biliopancreatic Diversion; D015992:Body Mass Index; D015331:Cohort Studies; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000473:pathology*; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000150:complications / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D054392:Adipokines
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