Adipokine Serum Levels Are Related to Liver Histology in Severely Obese Patients Undergoing Bariatric Surgery |
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Authors: | Marianna Argentou Dina G Tiniakos Menelaos Karanikolas Maria Melachrinou Maria G Makri Christos Kittas Fotis Kalfarentzos |
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Institution: | (1) Department of Surgery—Division of Nutritional Support and Morbid Obesity, Medical School, University of Patras, Patras, Greece;(2) Laboratory of Histology &; Embryology, Medical School, National &; Kapodistrian University of Athens, 75, M. Asias str, Goudi, Athens, 11527, Greece;(3) Department of Anesthesiology and Critical Care Medicine, Medical School, University of Patras, Patras, Greece;(4) Department of Pathology, Medical School, University of Patras, Patras, Greece;(5) Department of Endocrinology, Medical School, University of Patras, Patras, Greece; |
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Abstract: | Background Leptin, adiponectin, and resistin are adipokines linked to the development of insulin resistance, which plays a central role
in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). We aimed to define adipokine serum levels in severely obese
patients undergoing bariatric surgery and to correlate these with anthropometric and metabolic variables, liver function tests,
and histopathological parameters of NAFLD and nonalcoholic steatohepatitis (NASH).
Methods Surgical liver biopsies were obtained from 50 bariatric patients with no history of liver disease or significant alcohol consumption.
Serum leptin, adiponectin, and resistin levels were measured, and histology was assessed using Brunt’s and Kleiner’s scoring
systems.
Results Waist/hip ratio was significantly higher in men (p = 0.0001), and leptin (p = 0.036) and adiponectin (p = 0.0001) serum levels were higher in women. Forty-one of 50 patients (82%) had histological NAFLD, including 10 (20%) with
NASH. Nine patients (18%) had normal liver histology (obese control subgroup). In NAFLD patients, serum adiponectin was negatively
correlated with activity grade and fibrosis stage, resistin was negatively correlated with steatosis grade (p = 0.033), while leptin was not related to histology. Leptin/adiponectin ratio showed positive association with stage (p = 0.044). In the subgroup of NASH patients, adiponectin was negatively correlated only with stage (p = 0.01), while there was no correlation between leptin, resistin, or leptin/adiponectin and histology.
Conclusions Serum adiponectin and resistin levels are related to liver histology in bariatric patients and may be indicative of the histological
severity of NAFLD and the extent of hepatic steatosis, respectively. Serum leptin levels are not informative of underlying
liver histology in severely obese patients.
Marianna Argentou and Dina G. Tiniakos contributed equally to this work.
The authors disclose no conflict of interest. |
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Keywords: | Adipokines Leptin Adiponectin Resistin Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Obesity Bariatric surgery |
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