Chemerin, vaspin and insulin resistance in chronic hepatitis C

Abstract

Adipocytokine profile seems to play a distinct role in the pathogenesis of chronic hepatitis C (CHC). Chemerin and vaspin are recently described adipocytokines with various suggested functions and potential to modulate inflammatory response and insulin resistance (IR). We assessed chemerin, vaspin and leptin serum concentration and studied their association with IR laboratory and morphological features in patients with hepatitis C. The study included 40 patients with hepatitis C and 20 healthy volunteers, similar in age and body mass index (43.6 +/- 11.6 vs 40.9 +/- 11.8 years and 25.0 +/- 4.1 vs 23.9 +/- 3.3 kg/m(2), respectively). Patients had to have a normal lipid profile, and diabetes was an exclusion criteria. Serum chemerin and leptin levels and IR were significantly higher in patients with hepatitis C when compared to the controls (P = 0.02, P = 0.02 and P = 0.02, respectively), whereas vaspin level was significantly decreased (P = 0.01). Serum chemerin was negatively associated with necro-inflammatory grade (r = (-0.49), P = 0.01). The lowest levels of serum chemerin were found in patients with moderate/severe inflammation (P = 0.03). Serum leptin tended to be up-regulated in patients with minimal inflammatory activity. Serum vaspin was higher, although not significantly, when fibrosis was more advanced. IR was positively associated with fibrosis stage (r = 0.33, P = 0.03). Serum chemerin and leptin were related to each other (r = 0.45, P = 0.02).Our findings support a complex interaction between the analysed adipokines and pathogenesis of inflammatory process in CHC. The role of chemerin and vaspin in pathogenesis of inflammatory response should be further investigated.

Serum vaspin may be a good indicator of fibrosis in chronic hepatitis C and is not altered by antiviral therapy

“…Our study did not disclose a significant relationship between a serum vaspin level and insulin resistance (HOMA-IR), but we registered a tendency to higher serum vaspin in patients with HOMA-IR above 3. On the other hand, HOMA-IR was significantly associated with the stage of fibrosis supporting earlier findings that insulin resistance is one of important contributors to liver fibrosis in CHC [3,8,15].…”

“…Generally, the serum vaspin showed a positive association with the fibrosis stage, being in patients with advanced fibrosis almost as high as in controls. In our previous study we showed a tendency to elevated serum vaspin levels in CHC patients with septal fibrosis, however, that study was carried out on a smaller group of patients, not covering the whole spectrum of fibrosis stages [15].…”

“…Except for one study, based on a small histopathologically homogenous group of patients, there are no data showing serum levels of vaspin in CHC [15]. There are no data regarding the influence of antiviral treatment on vaspin serum concentration either.…”

Vaspin mRNA levels in the liver of morbidly obese women with nonalcoholic fatty liver disease

“…Steatosis was positively related tofibrosisstageandIR.HOMA-IRwassignificantly higherinpatientswithgrade0thanintherestofthe patients.Moreover,thedifferencewasstillsignificant comparingpatientswithgrade0and1tothosewith grade2and3ofsteatosis.Similarly,analysisofmRNA vaspinlevelsinthelivertissueshowedamarkeddifference with the higher intensity in patients with lipidstorageaffectingmorethan5%ofhepatocytes. Additionalanalysisrevealedfurtherincreaseofvaspin mRNA in patients with greater extent of steatosis, but the difference did not reach statistical significance.Theseresultsareinaccordancewithfindings of our previous studies regarding vaspin serum lev- The next histopathological feature included into thescoringsystemfordiagnosisofNASHishepatocyteballooning [31].Inourstudy,itsgradewasassociatedwithgradeoflobularinflammationandsteatosis.OurpreviousstudyinCHCpatientsshowed anegativerelationshipbetweenhepatocyteballooningandserumvaspinlevels [30].Incontrast,inNA-FLD serum vaspin levels were positively associated withhepatocyteballooning [27].However,themost recentstudydidnotfindsucharelationship [28].…”

Chemerin in Non-Alcoholic Fatty Liver Disease ? Up or Down?

“…In patients with chronic hepatitis C serum chemerin is strongly increased and this may be related to higher hepatic and/or adipocyte synthesis and / or inappropriate clearance of this protein from the circulation. Of note, in these patients systemic chemerin is even negatively associated with hepatic necro-inflammatory grade [31].…”