title: Adipokine Levels Versus Hepatic Histopathology in Bariatric Surgery Patients.
abstract: Obesity is a worldwide prevalent disease and is an underlying factor of non-alcoholic fatty liver disease (NAFLD). It has been understood as a chronic inflammatory state, being associated with the production of adipokines. The aim of this study was to analyze the levels of adipokines in the serum, visceral, and subcutaneous fat and to compare them with hepatic histopathology in morbidly obese patients.
  
  
  
  This is a cross-sectional observational study, which analyzed the findings of liver biopsy in patients undergoing bariatric surgery and who had performed analysis of adipokines mRNA expression (adiponectin-ADIPOQ, leptin-LEP, and resistin-RETN) in subcutaneous and visceral adipose tissue and circulating adipokines in serum. Liver biopsies performed were evaluated according to Kleiner criteria.
  
  
  
  The study analyzed 25 patients undergoing bariatric surgery. The sample was composed exclusively of women. There was a predominance of NAFLD, with 21 patients (84%) with intrahepatic fat accumulation. Twelve patients presented non-alcoholic steatohepatitis (NASH). Glycated hemoglobin levels (HbA1c) were elevated in NASH patients. ADIPOQ levels were directly correlated with high-density lipoprotein (HDL) cholesterol levels and inversely correlated with triglycerides and total cholesterol. LEP levels showed an inverse relationship with the degree of steatosis, and RETN levels showed an inverse relationship with fibrosis stages.
  
  
  
  Serum LEP levels were reduced in the presence of increased levels of intrahepatic fat, and serum levels of RETN were diminished in the presence of NASH. HbA1c levels were higher in the presence of NASH, indirectly reflecting insulin resistance. Moreover, ADIPOQ levels were related to blood lipid profile.
authors.affiliation: Medicine at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua São Manoel, 95 / 403; Bairro Rio Branco, Porto Alegre, CEP 90620-110, Brazil. rafaeldincao@hotmail.com.
authors.forename: Rafael Bergesch
authors.initials: RB
authors.lastname: D'Incao
authors.affiliation: Department and at Post Graduation Program, Hepatology at UFCSPA, Porto Alegre, Brazil.
authors.forename: Cristiane Valle
authors.initials: CV
authors.lastname: Tovo
authors.affiliation: Department and at Post Graduation Programs, Biosciences, Pathology and Health Sciences at UFCSPA, Porto Alegre, Brazil.
authors.forename: Vanessa Suñé
authors.initials: VS
authors.lastname: Mattevi
authors.affiliation: UFCSPA, Porto Alegre, Brazil.
authors.forename: Diego Olschowsky
authors.initials: DO
authors.lastname: Borges
authors.affiliation: Department of Pathology from Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, Brazil.
authors.forename: Jane Maria
authors.initials: JM
authors.lastname: Ulbrich
authors.affiliation: Department and at Post Graduation Program, Hepatology at UFCSPA, Porto Alegre, Brazil.
authors.forename: Gabriela Perdomo
authors.initials: GP
authors.lastname: Coral
authors.affiliation: Surgery Department, HNSC, Porto Alegre, Brazil.
authors.forename: Mauricio Jacques
authors.initials: MJ
authors.lastname: Ramos
authors.affiliation: Surgery Department, HNSC, Porto Alegre, Brazil.
authors.forename: Nelson Guardiola
authors.initials: NG
authors.lastname: Meinhardt
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D050110:Bariatric Surgery; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000737:chemistry* / Q000473:pathology; D008099:Liver / Q000737:chemistry / Q000473:pathology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000209:etiology / Q000473:pathology*; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000473:pathology / Q000601:surgery*; D050151:Subcutaneous Fat / Q000737:chemistry* / Q000473:pathology
chemical_list: D054392:Adipokines
keywords: Adipokines; Bariatric Surgery; NAFLD; NASH; Obesity