title: Hypoadiponectinemia and its association with liver fibrosis in morbidly obese patients.
abstract: BACKGROUND
  Reduced serum levels of adiponectin have been associated with insulin resistance and non-alcoholic fatty liver disease (NAFLD). However, the relationship between serum adiponectin levels and hepatic histology in NAFLD is controversial. The aim of this study was to explore associations between plasma adiponectin concentrations and liver histology in morbidly obese patients.
  
  
  METHODS
  We conducted a case-control study including obese patients undergoing bariatric surgery and normal controls. Anthropometric, standard biochemical variables as well as plasma adiponectin and leptin levels were determined. Liver biopsy was performed in all patients at the time of surgery.
  
  
  RESULTS
  Seventy morbidly obese patients (mean BMI, 40.6 ± 5.6 kg/m(2)) met the inclusion criteria and were compared with 69 controls (mean BMI, 22.8 ± 1.6 kg/m(2), p = 0.0001). Thirty patients (43%) had NAFLD and 20 (28%) of them fulfilled the histological criteria for steatohepatitis. Obesity was associated with increased leptin and decreased adiponectin levels. NAFLD patients exhibited decreased levels of serum adiponectin compared with matched controls [median (Q1-Q3), 3.9 (3.2-4.3) vs. 8.6 (6.5-9.2) μg/mL, p < 0.0001]. In univariate analysis, age, gender, type 2 diabetes mellitus, BMI, HOMA-IR, aspartate aminotransferase (AST), alanine aminotransferase, serum glucose, and adiponectin levels were independently associated with hepatic fibrosis. In multivariate analysis, AST [OR = 1.082 (1.000-1.170)], age [OR = 1.119 (1.023-1.225)], and serum adiponectin levels [OR = 0.529 (0.299-0.936)] were significantly associated with the presence of liver fibrosis.
  
  
  CONCLUSIONS
  NAFLD patients have lower plasma adiponectin concentrations than control subjects. Low adiponectin levels are associated with more severe liver histology. Serum adiponectin may be useful to estimate the severity of liver damage in obese patients with NAFLD.
authors.affiliation: Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
authors.forename: Leyla
authors.initials: L
authors.lastname: Nazal
authors.forename: Arnoldo
authors.initials: A
authors.lastname: Riquelme
authors.forename: Nancy
authors.initials: N
authors.lastname: Solís
authors.forename: Margarita
authors.initials: M
authors.lastname: Pizarro
authors.forename: Alex
authors.initials: A
authors.lastname: Escalona
authors.forename: Mauricio
authors.initials: M
authors.lastname: Burotto
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Méndez
authors.forename: Catalina
authors.initials: C
authors.lastname: Saint-Jean
authors.forename: María José
authors.initials: MJ
authors.lastname: Concha
authors.forename: Stefano
authors.initials: S
authors.lastname: Giovanni
authors.forename: Diego
authors.initials: D
authors.lastname: Awruch
authors.forename: Arturo
authors.initials: A
authors.lastname: Morales
authors.forename: Rene
authors.initials: R
authors.lastname: Baudrand
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Carrasco
authors.forename: María Angélica
authors.initials: MA
authors.lastname: Domínguez
authors.forename: Oslando
authors.initials: O
authors.lastname: Padilla
authors.forename: Manuel
authors.initials: M
authors.lastname: Espinoza
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Miquel
authors.forename: Flavio
authors.initials: F
authors.lastname: Nervi
authors.forename: Marco
authors.initials: M
authors.lastname: Arrese
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D005234:Fatty Liver / Q000097:blood / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009767:Obesity, Morbid / Q000097:blood / Q000453:epidemiology*; D012372:ROC Curve; D055815:Young Adult
chemical_list: D052242:Adiponectin