title: Hepatic tumor necrosis factor-α, leptin and adiponectin expression in morbid obese patients: Clinicopathological correlations.
abstract: CONCLUSIONS
  
  
  
  BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is associated with obesity. We retrospectively studied the clinicopathology and different hepatic adipocytokine expressions between nonalcoholic steatohepatitis (NASH) and non-NASH in morbid obesity.
  
  
  METHODS
  We enrolled 40 patients undergoing liver biopsy during bariatric surgery. We analyzed hepatic mRNA and immunohistochemistry of TNF-α, leptin, adiponectin and adiponectin receptor.
  
  
  RESULTS
  Thirty patients (75%) presented with NASH, including 11 with mild fibrosis and 19 with advanced fibrosis. The HbA1c (P = 0.000), AST (P = 0.000), ALT (P = 0.000), GGT (P = 0.016) and liver fibrosis (P = 0.028) have statistically difference between NASH and non-NASH groups. Steatosis was the only significant factor (r = 0.348, P < 0.05) associated with TNF-α mRNA level. Adiponectin mRNA was inversely associated with C-peptide (r = -0.416, P < 0.05) and uric acid level (r = -0.426, P < 0.05). The best predictors for TNF-α immunostain were hemoglobin (r = 0.432, P < 0.01), AST (r = 0.371, P < 0.05), lobular inflammation (r = 0.315, P < 0.05), portal inflammation (r = 0.331, P < 0.05), and NAS (r = 0.365, P < 0.05). Leptin immunostain was correlated with C-peptide (r = 0.356, P < 0.05) and portal inflammation (r = 0.334, P < 0.05). The AdipoRII immunoexpression was negatively correlated with systolic blood pressure (r = -0.481, P < 0.01). Multivariate linear regressions of adipocytokine profile related mostly to age, gender, systolic blood pressure, serum uric acid, steatosis, NAS and portal inflammation.
  
  
  CONCLUSIONS
  Although different adipocytokines may be associated with NAFLD progression in morbid obesity, their major correlations in the pathogenesis of obesity-related NASH are not clear. Additional confirmatory studies are deserved.
authors: Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taiwan.
authors: Phui-Ly
authors: PL
authors: Liew
authors: Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taiwan.
authors: Chi-Long
authors: CL
authors: Chen
authors: Department of International Business, Ching-Yun University, Jhongli City, Taiwan.
authors: Yi-Chih
authors: YC
authors: Lee
authors: Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, Taiwan.
authors: Ming-Te
authors: MT
authors: Huang
authors: Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taiwan.
authors: Weu
authors: W
authors: Wang
authors: 3 F, Department of Surgery, Min-Sheng General Hospital, Taoyuan Hsien, Taiwan. Electronic address:wjlee_obessurg_tw@yahoo.com.tw.
authors: Wei-Jei
authors: WJ
authors: Lee