Serum adipokines might predict liver histology findings in non-alcoholic fatty liver disease.
OBJECTIVE
To assess significance of serum adipokines to determine the histological severity of non-alcoholic fatty liver disease.


METHODS
Patients with persistent elevation in serum aminotransferase levels and well-defined characteristics of fatty liver at ultrasound were enrolled. Individuals with a history of alcohol consumption, hepatotoxic medication, viral hepatitis or known liver disease were excluded. Liver biopsy was performed to confirm non-alcoholic liver disease (NAFLD). The degrees of liver steatosis, lobular inflammation and fibrosis were determined based on the non-alcoholic fatty liver activity score (NAS) by a single expert pathologist. Patients with a NAS of five or higher were considered to have steatohepatitis. Those with a NAS of two or lower were defined as simple fatty liver. Binary logistic regression was used to determine the independent association of adipokines with histological findings. Receiver operating characteristic (ROC) analysis was employed to determine cut-off values of serum adipokines to discriminate the grades of liver steatosis, lobular inflammation and fibrosis.


RESULTS
Fifty-four participants aged 37.02 ± 9.82 were enrolled in the study. Higher serum levels of visfatin, IL-8, TNF-α levels were associated independently with steatosis grade of more than 33% [β = 1.08 (95%CI: 1.03-1.14), 1.04 (95%CI: 1.008-1.07), 1.04 (95%CI: 1.004-1.08), P < 0.05]. Elevated serum IL-6 and IL-8 levels were associated independently with advanced lobular inflammation [β = 1.4 (95%CI: 1.09-1.8), 1.07 (95%CI: 1.003-1.15), P < 0.05]. Similarly, higher TNF-α, resistin, and hepcidin levels were associated independently with advanced fibrosis stage [β = 1.06 (95%CI: 1.002-1.12), 19.86 (95%CI: 2.79-141.19), 560.72 (95%CI: 5.98-5255.33), P < 0.05]. Serum IL-8 and TNF-α values were associated independently with the NAS score, considering a NAS score of 5 as the reference value [β = 1.05 (95%CI: 1.01-1.1), 1.13 (95%CI: 1.04-1.22), P < 0.05].


CONCLUSIONS
Certain adipokines may determine the severity of NAFLD histology accurately.
Raika Jamali, Research Development Center, Sina Hospital, Tehran 15614, Iran.
Raika
R
Jamali
Raika Jamali, Research Development Center, Sina Hospital, Tehran 15614, Iran.
Mohsen
M
Razavizade
Raika Jamali, Research Development Center, Sina Hospital, Tehran 15614, Iran.
Abbas
A
Arj
Raika Jamali, Research Development Center, Sina Hospital, Tehran 15614, Iran.
Mohammad Hossein
MH
Aarabi
D054392:Adipokines / Q000097:blood*; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology*; D008111:Liver Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000473:pathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index
D054392:Adipokines; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators
Adipokine; Adiponectin; Hepcidin; Histology; Interleukin; Non-alcoholic fatty liver disease; Resistin; Tumor necrosis factor; Visfatin