title: Adipokines levels are associated with the severity of liver disease in patients with alcoholic cirrhosis.
abstract: OBJECTIVE
  To investigate the adipokine levels of leptin, adiponectin, resistin, visfatin, retinol-binding protein 4 (RBP4), apelin in alcoholic liver cirrhosis (ALC).
  
  
  METHODS
  Forty non-diabetic ALC patients [median age: 59 years, males: 35 (87.5%), Child-Pugh (CP) score: median 7 (5-12), CP A/B/C: 18/10/12, Model for End-stage Liver Disease (MELD): median 10 (6-25), follow-up: median 32.5 mo (10-43)] were prospectively included. The serum adipokine levels were estimated in duplicate by ELISA. Somatometric characteristics were assessed with tetrapolar bioelectrical impedance analysis. Pearson's rank correlation coefficient was used to assess possible associations with adipokine levels. Univariate and multivariate Cox regression analysis was used to determine independent predictors for overall survival.
  
  
  RESULTS
  Body mass index: median 25.9 (range: 20.1-39.3), fat: 23.4% (7.6-42.1), fat mass: 17.8 (5.49-45.4), free fat mass: 56.1 (39.6-74.4), total body water (TBW): 40.6 (29.8-58.8). Leptin and visfatin levels were positively associated with fat mass (P < 0.001/P = 0.027, respectively) and RBP4 with TBW (P = 0.025). Median adiponectin levels were significantly higher in CPC compared to CPA (CPA: 7.99 ± 14.07, CPB: 7.66 ± 3.48, CPC: 25.73 ± 26.8, P = 0.04), whereas median RBP4 and apelin levels decreased across the spectrum of disease severity (P = 0.006/P = 0.034, respectively). Following adjustment for fat mass, visfatin and adiponectin levels were significantly increased from CPA to CPC (both P < 0.001), whereas an inverse correlation was observed for both RBP4 and apelin (both P < 0.001). In the multivariate Cox regression analysis, only MELD had an independent association with overall survival (HR = 1.53, 95%CI: 1.05-2.32; P = 0.029).
  
  
  CONCLUSIONS
  Adipokines are associated with deteriorating liver function in a complex manner in patients with alcoholic liver cirrhosis.
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kalafateli
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Triantos
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Tsochatzis
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Marina
authors.initials: M
authors.lastname: Michalaki
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Koutroumpakis
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Thomopoulos
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Venetsanea
authors.initials: V
authors.lastname: Kyriazopoulou
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Jelastopulu
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Andrew
authors.initials: A
authors.lastname: Burroughs
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Lambropoulou-Karatza
authors.affiliation: Maria Kalafateli, Christos Triantos, Efstratios Koutroumpakis, Konstantinos Thomopoulos, Vasiliki Nikolopoulou, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Nikolopoulou
mesh_terms: D054392:Adipokines / Q000097:blood*; D050154:Adiposity; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D018450:Disease Progression; D017097:Electric Impedance; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016014:Linear Models; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D054392:Adipokines; D015415:Biomarkers
keywords: Adipokines; Adiponectin; Cirrhosis; Leptin; Resistin