Correlation between adiponectin level and the degree of fibrosis in patients with NAFLD

Abstract

Background Non-alcoholic Fatty Liver Disease (NAFLD) is one of the most prevalent chronic liver diseases particularly in Egypt. It is defined as accumulation of lipids inside the hepatocytes, in absence of other etiologies of hepatic damage. It is frequently associated with obesity, diabetes mellitus and metabolic syndrome. Objective To find out the correlation between the degree of liver fibrosis in Non-alcoholic Fatty Liver Disease patients and their serum Adiponectin level as a future non-invasive method for assessment of liver fibrosis to substitute liver biopsy to avoid its hazardous complication. Also to study the correlation between diabetes mellitus as well as obesity and serum Adiponetctin level. Patients and Methods 50 patients were selected to participate in our study based on our inclusion criteria. They were recruited from the Internal Medicine department, Gastro-intestinal clinic in AlDemerdash Hospital using a convenient sampling method. Diagnoses of NAFLD (Non-alcoholic fatty liver disease) was confirmed by laboratory markers (AST, ALT, Lipid profile), ultrasound as well as fibroscan examination. Results Analyzing adiponectin levels showed that -besides its significant correlation with BMI, hypertension, diabetes mellitus and dyslipidemia- it was significantly lower in high grade fibrosis group compared to low grade fibrosis group with P-value of (0.000) and a cutoff value for stage 3/4 fibrosis of about 2.31μg/ml which marked a promising hope of adeponictin being of protective value against liver fibrosis. However, more studies performed on populations of different sizes and characteristics are recommended to allow more accurate generalization of the results and hopefully exploring a new horizon for the follow up and treatment of patients with chronic liver disease especially NAFLD. Conclusion Adiponectin is an abundant adipocyte-derived protein with well-established antiatherogenic, insulin-sensitizing and anti-inflammatory properties. The liver is a major target organ for adiponectin especially in fatty liver diseases and this adipocytokine has the ability to control many liver functions including metabolism, inflammation and fibrosis. Both serum levels and hepatic adiponectin receptor expression are decreased in NAFLD. Therefore, either adiponectin itself or adiponectin-inducing agents might be of key therapeutic interest in the near future in the treatment of NAFLD.