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Adipokine Levels Versus Hepatic Histopathology in Bariatric Surgery Patients

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Abstract

Background

Obesity is a worldwide prevalent disease and is an underlying factor of non-alcoholic fatty liver disease (NAFLD). It has been understood as a chronic inflammatory state, being associated with the production of adipokines. The aim of this study was to analyze the levels of adipokines in the serum, visceral, and subcutaneous fat and to compare them with hepatic histopathology in morbidly obese patients.

Methods

This is a cross-sectional observational study, which analyzed the findings of liver biopsy in patients undergoing bariatric surgery and who had performed analysis of adipokines mRNA expression (adiponectin—ADIPOQ, leptin—LEP, and resistin—RETN) in subcutaneous and visceral adipose tissue and circulating adipokines in serum. Liver biopsies performed were evaluated according to Kleiner criteria.

Results

The study analyzed 25 patients undergoing bariatric surgery. The sample was composed exclusively of women. There was a predominance of NAFLD, with 21 patients (84%) with intrahepatic fat accumulation. Twelve patients presented non-alcoholic steatohepatitis (NASH). Glycated hemoglobin levels (HbA1c) were elevated in NASH patients. ADIPOQ levels were directly correlated with high-density lipoprotein (HDL) cholesterol levels and inversely correlated with triglycerides and total cholesterol. LEP levels showed an inverse relationship with the degree of steatosis, and RETN levels showed an inverse relationship with fibrosis stages.

Conclusion

Serum LEP levels were reduced in the presence of increased levels of intrahepatic fat, and serum levels of RETN were diminished in the presence of NASH. HbA1c levels were higher in the presence of NASH, indirectly reflecting insulin resistance. Moreover, ADIPOQ levels were related to blood lipid profile.

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Author information

Authors and Affiliations

  1. Medicine at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua São Manoel, 95 / 403; Bairro Rio Branco, Porto Alegre, CEP 90620-110, Brazil

    Rafael Bergesch D’Incao

  2. Department and at Post Graduation Program, Hepatology at UFCSPA, Porto Alegre, Brazil

    Cristiane Valle Tovo & Gabriela Perdomo Coral

  3. Department and at Post Graduation Programs, Biosciences, Pathology and Health Sciences at UFCSPA, Porto Alegre, Brazil

    Vanessa Suñé Mattevi

  4. UFCSPA, Porto Alegre, Brazil

    Diego Olschowsky Borges

  5. Department of Pathology from Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, Brazil

    Jane Maria Ulbrich

  6. Surgery Department, HNSC, Porto Alegre, Brazil

    Mauricio Jacques Ramos & Nelson Guardiola Meinhardt

Authors
  1. Rafael Bergesch D’Incao
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  2. Cristiane Valle Tovo
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  3. Vanessa Suñé Mattevi
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  4. Diego Olschowsky Borges
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  5. Jane Maria Ulbrich
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  6. Gabriela Perdomo Coral
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  7. Mauricio Jacques Ramos
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  8. Nelson Guardiola Meinhardt
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Corresponding author

Correspondence to Rafael Bergesch D’Incao.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Statement

This study was submitted to and approved by the Research Ethics Committee of Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and of Hospital Nossa Senhora da Conceição (HNSC). All participants signed an inform consent form authorizing adipose tissue and blood sample collection previous to surgery procedures and their storage for further studies. These samples were collected for a previous larger study, and their utilization in the present study and collection of information from routine liver biopsies performed during surgery from their medical records was authorized by both institutions.

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D’Incao, R.B., Tovo, C.V., Mattevi, V.S. et al. Adipokine Levels Versus Hepatic Histopathology in Bariatric Surgery Patients. OBES SURG 27, 2151–2158 (2017). https://doi.org/10.1007/s11695-017-2627-4

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  • DOI: https://doi.org/10.1007/s11695-017-2627-4

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