title: Serum adiponectin and transient elastography as non-invasive markers for postoperative biliary atresia.
abstract: BACKGROUND
  Biliary atresia (BA) is a progressive inflammatory disorder of the extrahepatic bile ducts leading to the obliteration of bile flow. The purpose of this study was to determine serum adiponectin in BA patients and to investigate the relationship of adiponectin with clinical parameters and liver stiffness scores.
  
  
  METHODS
  Sixty BA patients post Kasai operation and 20 controls were enrolled. The mean age of BA patients and controls was 9.6 ± 0.7 and 10.1 ± 0.7 years, respectively. BA patients were classified into two groups according to their serum total bilirubin (TB) levels (non-jaundice, TB < 2 mg/dl vs. jaundice, TB ≥ 2 mg/dl) and liver stiffness (insignificant fibrosis, liver stiffness < 7 kPa vs. significant fibrosis, liver stiffness ≥ 7 kPa). Serum adiponectin levels were analyzed by enzyme-linked immunosorbent assay. Liver stiffness scores were examined by transient elastography (FibroScan).
  
  
  RESULTS
  BA patients had markedly higher serum adiponectin levels (15.5 ± 1.1 vs. 11.1 ± 1.1 μg/ml, P = 0.03) and liver stiffness than controls (30.1 ± 3.0 vs. 5.1 ± 0.5 kPa, P < 0.001). Serum adiponectin levels were significantly elevated in BA patients with jaundice compared with those without jaundice (24.4 ± 1.4 vs. 11.0 ± 0.7 μg/ml, P < 0.001). In addition, BA patients with significant liver fibrosis had remarkably greater serum adiponectin than insignificant fibrosis counterparts (17.7 ± 1.2 vs. 9.4 ± 1.1 μg/ml, P < 0.001). Subsequent analysis revealed that serum adiponectin was positively correlated with total bilirubin, hyaluronic acid, and liver stiffness (r = 0.58, r = 0.46, and r = 0.60, P < 0.001, respectively).
  
  
  CONCLUSIONS
  Serum adiponectin and liver stiffness values were higher in BA patients compared with normal participants. The elevated serum adiponectin levels also positively correlated with the degree of hepatic dysfunction and liver fibrosis. Accordingly, serum adiponectin and transient elastography could serve as the useful non-invasive biomarkers for monitoring the severity and progression in postoperative BA.
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. sittisak_honsawek@hotmail.com
authors.forename: Sittisak
authors.initials: S
authors.lastname: Honsawek
authors.forename: Maneerat
authors.initials: M
authors.lastname: Chayanupatkul
authors.forename: Voranush
authors.initials: V
authors.lastname: Chongsrisawat
authors.forename: Apiradee
authors.initials: A
authors.lastname: Theamboonlers
authors.forename: Kesmanee
authors.initials: K
authors.lastname: Praianantathavorn
authors.forename: Wanvisa
authors.initials: W
authors.lastname: Udomsinprasert
authors.forename: Paisarn
authors.initials: P
authors.lastname: Vejchapipat
authors.forename: Yong
authors.initials: Y
authors.lastname: Poovorawan
mesh_terms: D052242:Adiponectin / Q000097:blood*; D001656:Biliary Atresia / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D018450:Disease Progression; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007565:Jaundice / Q000097:blood / Q000473:pathology; D007582:Jejunostomy; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D011184:Postoperative Period; D016896:Treatment Outcome
chemical_list: D052242:Adiponectin; D015415:Biomarkers