Abstract :
Objectives: Background: Non-alcoholic fatty liver disease (NAFLD) is a hepatic manifestation of meta-
bolic syndrome that is associated with obesity and insulin resistance. Non-alcoholic steatohepatitis (NASH) can
progress to cirrhosis and advanced fibrosis. Chemerin, vaspin and omentin-1 are new adipokines releasing from
adipose tissue. Adipokines may play a role in the pathogenesis of NAFLD.
Objectives: We aimed to assess chemerin, vaspin and omentin-1 levels in patients with NAFLD, and to
identify predictive markers for NASH and advanced fibrosis.
Methods: A cross-sectional study was performed from January to December 2012. Data on anthropo-
metric measurements, blood chemistry, index of insulin resistance (HOMA-IR) and adipokines (chemerin, vaspin
and omentin-1) were collected in patients with NAFLD along with age- and sex-matched controls. NAFLD pa-
tients needed to have NAFLD-confirmed liver biopsy within 2 years before enrollment. NAFLD activity score
(NAS) and fibrosis staging were assessed according to Kleiner et al. NAS ≥ 5 was defined as NASH. Fibrosis stage
≥ 3 was defined as advanced fibrosis. Adipokine levels were determined by enzyme-linked immunosorbent assay.
Results: A total of 60 NAFLD patients and 55 controls were enrolled. Mean (SD) ages of NAFLD
patients and controls were 54.7 (8.7) and 46.9 (8.1) years. The anthropometric data, liver chemistry, lipid profiles
and HOMA-IR in NAFLD group were significantly different from control group. Chemerin, vaspin and omentin-
1 in NAFLD group were higher than in control group [194.58 vs. 120.51 (p<0.001), 0.163 vs. 0.156 (p<0.292),
452.25 vs. 372.1 ng/mL (p<0.006)]. There were 22 (36.7%) patients with NASH, and 38.3 (63.3%) patients with
simple steatosis. Chemerin, vaspin and omentin-1 levels in NASH and simple steatosis were not different. Twenty-
one patients (35%) had advanced fibrosis. From univariate analysis age, NAS, hemoglobin A1C, omentin-1 were
significantly elevated in advanced fibrosis patients. Age and NAS were independently associated with advanced
fibrosis.
Conclusions: Chemerin and omentin-1 are elevated in NAFLD patients. Chemerin, omentin-1 and
vaspin are not associated with advanced fibrosis and NASH. Age and NAS are related to advanced fibrosis. The
role of adipokines in the pathogenesis of NAFLD requires further study. |
file/Thai-Journal-of-gastroenterology-vol-15-no-1-4997356.pdf