Abstract
Background. Steatosis is a manifestation of the metabolic syndrome often associated with release of liver enzymes and inflammatory adipocytokines linked to cardiovascular risk. Gamma-glutamyltransferase (GGT) is one sensitive liver marker recently identified as an independent cardiovascular risk factor. Mechanisms involved in enhanced hepatic lipogenesis causing steatosis are not yet identified and are usually linked to insulin resistance (IR). Acylation stimulating protein (ASP), a potent lipogenic factor, was recently shown to increase in patients with steatosis and was implicated in its pathogenesis. Aim. To investigate the association of plasma ASP levels with liver and metabolic risk markers in acute coronary syndrome (ACS) patients. Methods. 28 patients and 30 healthy controls were recruited. Their anthropometrics, lipid profile, liver markers, insulin, and ASP levels were measured. Results. In the patients, ASP, liver, and metabolic risk markers were markedly higher than in the controls. ASP strongly predicted GGT levels (B = 0.75, P < 0.0001), followed by triglycerides (B = 0.403, P = 0.017), together determining 57.6% variation in GGT levels. Insulin and IR correlated with metabolic risk components but not with liver enzymes. Conclusion. The strong association of ASP with GGT in ACS patients suggests that ASP, independent of IR, may contribute to a vicious cycle of hepatic lipogenic stimulation and GGT release promoting atherogenesis.
Highlights
Steatosis is the liver manifestation of the metabolic syndrome [1, 2] often associated with release of liver enzymes, inflammatory adipocytokines, interleukins, and complement factors, many of which are linked to cardiovascular risk [3,4,5,6]
Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma glutamyltransferase (GGT) are the main liver enzymes used as surrogate markers of liver steatosis after ruling out infectious hepatitis, alcohol abuse, and damage to extrahepatic tissues [3, 7, 8]
The aim of this study is to investigate the association of the major lipogenic hormones Acylation stimulating protein (ASP) and insulin with liver enzymes, as surrogate markers of liver steatosis, and other metabolic syndrome components and metabolic risk factors in patients who developed acute coronary syndrome compared to healthy controls
Summary
Steatosis is the liver manifestation of the metabolic syndrome [1, 2] often associated with release of liver enzymes, inflammatory adipocytokines, interleukins, and complement factors, many of which are linked to cardiovascular risk [3,4,5,6]. Steatosis is a manifestation of the metabolic syndrome often associated with release of liver enzymes and inflammatory adipocytokines linked to cardiovascular risk. Gamma-glutamyltransferase (GGT) is one sensitive liver marker recently identified as an independent cardiovascular risk factor. Aim. To investigate the association of plasma ASP levels with liver and metabolic risk markers in acute coronary syndrome (ACS) patients. The strong association of ASP with GGT in ACS patients suggests that ASP, independent of IR, may contribute to a vicious cycle of hepatic lipogenic stimulation and GGT release promoting atherogenesis
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