Serum Adiponectin in Patients with Chronic Liver Disease
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- Category: Vol. 78, June 2010
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Serum Adiponectin in Patients with Chronic Liver Disease,MAHMOUD MAHFOUZ, HODA ABD EL-SATAR, MONA HEGAZY and LAYLA AHMED RASHED
Abstract
Liver cirrhosis is a catabolic disease with patients exhibiting increased resting energy expenditure, loss of body fat mass and increased lipid peroxidation for energy generation due to reduced clearance of gut derived bacteria leads to persistent macrophage activation, cytokines are then released impacting on the wasting syndrome in liver cirrhosis. TNF-a especially has been implicated. Liver function deterioration seems to be a major determinant of the circulating adiponectin level in patients with established liver cirrhosis. Adiponectin is a 244 amino acid-molecule that belongs to the group of adipocytok-ines, secreted by adipocytes, with antidiabetic and antiathero-genic actions. Two adiponectin receptors, adiponectin R1 and R2, have been cloned, several types, including macrophages, express adiponectin receptors. Liver expresses both receptor genes and has the higher expression of R2 in the organs. Low plasma levels of adiponectin are associated with increased insulin resistance and with an altered lipid pattern. On the other hand, low serum adipoenctin levels have been reported in non-alcoholic fatty liver disease, where they even be asso-ciated with increased transaminase levels and worse histology.
The aim of the work is to study the serum adiponectin in patients with chronic liver disease and their relation to severity of illness.
Subject and Methods: The study included 52 patients with chronic liver diseases and 10 normal subjects as a control group.
Results: Showed elevated mean serum adiponectin in cases (52 patients) compared to control subjects with a mean value of 12.59±3.6 and 7.8±0.79mg/ml respectively (p-value 0.000). The mean serum adiponectin was significantly higher in patients with esophageal varices than control subjects p-value 0.000. The mean value in patients with no varices, small and large varices were 9.58±1.5, 13.7±4.06 and 13.3±3.3mg/ml. Patients with small varices showed higher mean adiponectin value than those with no varices p-value 0.003. The mean serum adiponectin was higher in Child group C than Child A and B with a level of 13.19, 12.9, 10.4mg/ml respectively. However, the level did not reach the statistical significance p-value 0.120. Serum adiponectin was found to be positively correlated to insulin level and to portal vein diameter with p-value 0.08 and 0.07 respectively. Whereas, it was negatively correlated with prothrombin concentration p-value 0.09. Serum adiponectin did not correlate with age, sex, BMI, total bilirubin aspartate aminotransferase.