Serum adipokine levels predictive of liver injury in non-alcoholic fatty liver disease

Authors

  • Maud Lemoine,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. Inserm, UMRS 938, Paris, France
    3. AP-HP, Hôpital Saint-Antoine, Service d'Hépatologie, Paris, France
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  • Vlad Ratziu,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. AP-HP, Hôpital Pitié-Salpétrière, Service d'Hépatologie, Paris, France
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  • Minji Kim,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. Inserm, UMRS 938, Paris, France
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  • Mustapha Maachi,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. Inserm, UMRS 938, Paris, France
    3. AP-HP, Hôpital Tenon, Service de Biochimie et d'Hormonologie, Paris, France
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  • Dominique Wendum,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. AP-HP, Hôpital Saint-Antoine, Service d'Anatomo-pathologie, Paris, France
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  • François Paye,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. AP-HP, Hôpital Saint-Antoine, Service de Chirurgie Digestive, Paris, France
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  • Jean Philippe Bastard,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. Inserm, UMRS 938, Paris, France
    3. AP-HP, Hôpital Tenon, Service de Biochimie et d'Hormonologie, Paris, France
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  • Raoul Poupon,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. AP-HP, Hôpital Saint-Antoine, Service d'Hépatologie, Paris, France
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  • Chantal Housset,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. Inserm, UMRS 938, Paris, France
    3. AP-HP, Hôpital Tenon, Service de Biochimie et d'Hormonologie, Paris, France
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  • Jacqueline Capeau,

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. Inserm, UMRS 938, Paris, France
    3. AP-HP, Hôpital Saint-Antoine, Service d'Anatomo-pathologie, Paris, France
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  • Lawrence Serfaty

    1. Universite Pierre et Marie Curie, Faculté de Médecine, Paris, France
    2. Inserm, UMRS 938, Paris, France
    3. AP-HP, Hôpital Saint-Antoine, Service d'Hépatologie, Paris, France
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Correspondence
Dr Lawrence Serfaty, Service d'Hépatologie, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, France
Tel: +33 1 49 28 29 23
Fax: +33 1 49 28 21 07
e-mail: lawrence.serfaty@sat.aphp.fr

Abstract

Aims: The aim of this study was to determine whether serum levels of adipokines, including the ratio of serum adiponectin to leptin (A/L) levels could predict the severity of liver injury in patients with non-alcoholic fatty liver disease (NAFLD).

Patients and methods: Fifty-seven patients with biopsy-proven non-alcoholic steatohepatitis (NASH) (mean age 51±12, sex ratio 1), 17 with simple steatosis (mean age 47±12, sex ratio 1.4) and 10 controls without steatosis (mean age 51±11, sex ratio 4) were investigated. In all subjects, serum concentrations of triglycerides, ultrasensitive C reactive protein, leptin, adiponectin, soluble tumour necrosis factor receptor 1, interleukin (IL)-6 and Homeostasis Model Assessment Method (HOMA) were measured. Hepatic expression of adiponectin and its two receptors was assessed by quantitative reverse transcriptase polymerase chain reaction.

Results: Body mass index (BMI) and HOMA were correlated positively with leptin levels (r=0.44 and 0.28 respectively) and negatively with the A/L ratio (r=0.51 and 0.41 respectively). Independent parameters associated with NASH vs steatosis were HOMA>3 [odds ratio (OR)=6.9] and A/L ratio <1.4 103 (OR=5.2). The combination of HOMA with A/L ratio showed an area under the receiver operating characteristic curve of 0.82 for distinguishing between NASH and steatosis. Extensive portal fibrosis was present in 17 (23%) patients with NAFLD. Three independent parameters were associated with fibrosis: age (OR=1.1), BMI (OR=1.3) and high IL-6 levels (OR=1.6). The hepatic expression of adiponectin receptor 2 was significantly higher in patients with NASH compared with controls and was related with necroinflammatory injury.

Conclusions: This study shows that in patients with NAFLD, the combination of HOMA with A/L ratio may be a useful non-invasive approach to appreciate the severity of liver damage.

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