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Hypoadiponectinemia and its Association with Liver Fibrosis in Morbidly Obese Patients

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Abstract

Background

Reduced serum levels of adiponectin have been associated with insulin resistance and non-alcoholic fatty liver disease (NAFLD). However, the relationship between serum adiponectin levels and hepatic histology in NAFLD is controversial. The aim of this study was to explore associations between plasma adiponectin concentrations and liver histology in morbidly obese patients.

Methods

We conducted a case–control study including obese patients undergoing bariatric surgery and normal controls. Anthropometric, standard biochemical variables as well as plasma adiponectin and leptin levels were determined. Liver biopsy was performed in all patients at the time of surgery.

Results

Seventy morbidly obese patients (mean BMI, 40.6 ± 5.6 kg/m2) met the inclusion criteria and were compared with 69 controls (mean BMI, 22.8 ± 1.6 kg/m2, p = 0.0001). Thirty patients (43%) had NAFLD and 20 (28%) of them fulfilled the histological criteria for steatohepatitis. Obesity was associated with increased leptin and decreased adiponectin levels. NAFLD patients exhibited decreased levels of serum adiponectin compared with matched controls [median (Q1–Q3), 3.9 (3.2–4.3) vs. 8.6 (6.5–9.2) μg/mL, p < 0.0001]. In univariate analysis, age, gender, type 2 diabetes mellitus, BMI, HOMA-IR, aspartate aminotransferase (AST), alanine aminotransferase, serum glucose, and adiponectin levels were independently associated with hepatic fibrosis. In multivariate analysis, AST [OR = 1.082 (1.000–1.170)], age [OR = 1.119 (1.023–1.225)], and serum adiponectin levels [OR = 0.529 (0.299–0.936)] were significantly associated with the presence of liver fibrosis.

Conclusions

NAFLD patients have lower plasma adiponectin concentrations than control subjects. Low adiponectin levels are associated with more severe liver histology. Serum adiponectin may be useful to estimate the severity of liver damage in obese patients with NAFLD.

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Abbreviations

NAFLD:

Non-alcoholic fatty liver disease

NASH:

Non-alcoholic steatohepatitis

BMI:

Body mass index

ALT:

Alanine aminotransferase

HOMA-IR:

Homeostasis model assessment insulin resistance

ATP III:

Adult Treatment Panel III

CI:

Confidence interval

hs-CRP:

High-sensitivity C-reactive protein

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

ROC:

Receiver operating characteristics

OR:

Odds ratio

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Acknowledgments

This work was partially supported by grants of the National Commission for Scientific and Technological Research (CONICYT), FONDECYT no. 1080170 to M.A., and from the Office of Research affairs of the Pontificia Universidad Católica School of Medicine to L.N.

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Authors and Affiliations

  1. Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile

    Leyla Nazal, Arnoldo Riquelme, Nancy Solís, Margarita Pizarro, Juan Francisco Miquel, Flavio Nervi & Marco Arrese

  2. Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Alex Escalona & Diego Awruch

  3. Department of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Mauricio Burotto, Juan Ignacio Méndez, Catalina Saint-Jean, María José Concha, Stefano Giovanni & Arturo Morales

  4. Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Rene Baudrand

  5. Department of Pathology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Gonzalo Carrasco

  6. Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    María Angélica Domínguez, Oslando Padilla & Manuel Espinoza

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  1. Leyla Nazal
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Correspondence to Marco Arrese.

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Nazal, L., Riquelme, A., Solís, N. et al. Hypoadiponectinemia and its Association with Liver Fibrosis in Morbidly Obese Patients. OBES SURG 20, 1400–1407 (2010). https://doi.org/10.1007/s11695-009-0051-0

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