Study of Serum Adiponectin in Chronic Liver Disease and Cholestasis

Abstract

Purpose: Adiponectin is suggested to have a hepatoprotective effect. To date, there is minimal information available in the literature regarding changes in serum adiponectin levels in cirrhosis and cholestasis and the associated metabolic disturbances. Therefore, our aim was to elucidate the role of adiponectin in chronic liver disease and to correlate adiponectin level with liver functions &markers of the metabolic syndrome as body mass index and insulin resistance in these patients. Methods: 40 patients with different grades of cirrhosis, 30 patients with cirrhosis & cholestasis and 20 matched controls were studied. They were subjected to clinical assessment, BMI and Child score calculations, analysis of ALT, AST, alkaline phosphatase, GGT, C-reactive protein, HOMA index, adiponectin, abdominal ultrasonography & upper GI endoscopy. Results: Adiponectin was significantly higher in patients than controls (cirrhosis: 15.1 ± 12.14 μg/ml vs 4.7 ± 4.48 μg/ml, P < 0.05 and cirrhosis/cholestasis: 21.28 ± 10.2 μg/ml vs 4.7 ± 4.48 μg/ml, P= 0.001). Adiponectin correlated with bilirubin (r = 0.369, P < 0.05), ALT (r = 0.283, P < 0.05), AST (r = 0.367, P < 0.05), albumin (r =− 0.287, P < 0.05), prothrombin (r = 0.278, P= 0.053), ALP (r = 0.394, P < 0.005), GGT (r = 0.298, P < 0.05), CRP (r = 0.406, P < 0.05). Adiponectin didnot correlate with presence of ascites or esophageal varices nor did it correlate with BMI or HOMA index. Conclusion: adiponectin is elevated in cirrhosis and correlates with degree of hepatocellular injury and cholestasis. It could serve as a novel marker indicating cholestasis in liver cirrhosis. Adiponectin in cirrhosis does not correlate with parameters of body composition or metabolism but exclusively with reduced liver function.