Abstract
BackgroundInsulin resistance (IR) is frequently associated with chronic liver disease. There has been an increased interest in betatrophin protein and its involvement in the compensatory response to IR. We aimed to investigate the correlation of serum betatrophin levels with disease severity and the emergence of IR in cirrhotic patients. This study included 27 cirrhotic patients and 30 healthy participants who served as a control group. IR was assessed by the Homeostasis Model Assessment (HOMA-IR). Serum insulin and betatrophin levels were measured using Enzyme-Linked Immunosorbent Assay (ELISA).ResultsIR was existing in 74% of cirrhotic patients (p < 0.001). Subjects with IR had higher serum betatrophin levels than those without IR (p = 0.04). Serum betatrophin levels were significantly higher in cirrhotic patients than controls (p < 0.001). In addition, Child-Pugh class C patients had higher serum betatrophin levels than those with Child-Pugh class B cirrhosis (p = 0.01). Moreover, the highest serum betatrophin levels were detected in patients with tense ascites followed by those with moderate and mild ascites (p = 0.01). In the cirrhosis group, serum betatrophin levels correlated positively with fasting blood glucose levels (p < 0.001), fasting insulin levels (p = 0.006), HOMA-IR (p = 0.006), Child-Pugh score (p = 0.023), MELD score (p < 0.001), and INR (p = 0.005), and correlated negatively with platelets count (p = 0.01).ConclusionCirrhotic patients have higher serum betatrophin levels; moreover, these levels are positively correlated with disease severity as well as the emergence of insulin resistance.
Highlights
Insulin resistance (IR) is frequently associated with chronic liver disease
The liver plays a vital role in glucose homeostasis; chronic liver disease results in disturbances in glucose metabolism
Factors accounting for IR in the context of cirrhosis remain mostly undefined, there has been evidence that there is a circulating factor associated with insulin-resistant states [4, 5]
Summary
Insulin resistance (IR) is frequently associated with chronic liver disease. There has been an increased interest in betatrophin protein and its involvement in the compensatory response to IR. Insulin resistance (IR) is common in cirrhotic patients; it was reported that 57% of cirrhotic patients had IR [1] This phenomenon was observed in cirrhotic patients even before the disturbance of glucose tolerance became prominent. Compensation for this hormonal resistance occurs by increasing the secretory capacity and β-cell mass [2, 3]. It is a member of angiopoietin-like gene family (known as angiopoietin-like 8 (ANGPTL8)/Lipasin/ refeeding-induced fat and liver protein (RIFL) [7]. It is secreted under insulin-resistant conditions mainly from adipose tissue and liver [8, 9]. It was reported that serum betatrophin levels were altered under specific physiological states such as the postprandial state [10]
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