Abstract
BackgroundNon-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases, particularly in Egypt. It is defined as the accumulation of lipids inside the hepatocytes, in the absence of other etiologies of hepatic damage. It is frequently associated with obesity, diabetes mellitus, and metabolic syndrome. Adiponectin is an abundant adipocyte-derived protein with well-established anti-atherogenic, insulin-sensitizing, and anti-inflammatory properties. The liver is a major target organ for adiponectin especially in fatty liver diseases, and this adipocytokine has the ability to control many liver functions including metabolism, inflammation, and fibrosis. In this study, we aimed to find out the correlation between the degree of liver fibrosis in NAFLD patients and their serum adiponectin level as a future non-invasive method for the assessment of liver fibrosis to substitute liver biopsy to avoid its hazardous complication and also to study the correlation between diabetes mellitus as well as obesity and serum adiponectin level.ResultsFifty patients were selected to participate in our study based on our inclusion criteria. They were recruited from the Internal Medicine Department, Gastroenterology Clinic in Al-Demerdash Hospital using a convenient sampling method. Diagnosis of NAFLD was confirmed by laboratory markers: aspartate aminotransferase (AST), alanine aminotransferase (ALT), lipid profile, ultrasound, and FibroScan examination. Analyzing the adiponectin levels showed that besides its significant correlation with body mass index (BMI), hypertension, diabetes mellitus, and dyslipidemia, it was significantly lower in the high-grade fibrosis group compared to the low-grade fibrosis group with a P-value of (0.000) and a cutoff value for stage 3/4 fibrosis of about 2.31 μg/ml which marked a promising hope of adiponectin being of protective value against liver fibrosis.ConclusionBoth serum levels and hepatic adiponectin receptor expression are decreased in NAFLD. Therefore, either adiponectin itself or adiponectin-inducing agents might be of key therapeutic interest in the near future in the treatment of NAFLD.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases, in Egypt
Through the inhibition of lipid oxidation and increased fatty acid and triglycerides synthesis, is believed to be a key factor in the development of fatty liver. Insulin resistance states, such as obesity and diabetes, are characterized by elevated expression and production of several cytokines; of particular interest are cytokines produced by adipose tissue, the so-called adipokines, nuclear factor α (NFα), transforming growth factor β (TGFβ), and plasminogen activator inhibitor-1 (PAI-1)
The purpose of this study is to find the correlation between adiponectin and the degree of liver fibrosis in patients with NAFLD as a future substitution for liver biopsy to avoid its hazardous complications and to study the correlation between diabetes mellitus as well as obesity and serum adiponectin level. This was a cross-sectional study conducted on 50 Egyptian patients with a diagnosis of NAFLD recruited from Ain Shams University, Internal Medicine Department, Gastroenterology Clinic, between January 2019 and February 2020 using a convenient sampling method
Summary
Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases, in Egypt. Insulin resistance states, such as obesity and diabetes, are characterized by elevated expression and production of several cytokines; of particular interest are cytokines produced by adipose tissue, the so-called adipokines (adiponectin, leptin, resistin), nuclear factor α (NFα), transforming growth factor β (TGFβ), and plasminogen activator inhibitor-1 (PAI-1). Their role in the development of diabetes and other obesity complication has been suggested [35]
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