Correlation between adiponectin level and the degree of fibrosis in patients with non-alcoholic fatty liver disease

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases, particularly in Egypt. It is defined as the accumulation of lipids inside the hepatocytes, in the absence of other etiologies of hepatic damage. It is frequently associated with obesity, diabetes mellitus, and metabolic syndrome. Adiponectin is an abundant adipocyte-derived protein with well-established anti-atherogenic, 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. In this study, we aimed to find out the correlation between the degree of liver fibrosis in NAFLD patients and their serum adiponectin level as a future non-invasive method for the assessment of liver fibrosis to substitute liver biopsy to avoid its hazardous complication and also to study the correlation between diabetes mellitus as well as obesity and serum adiponectin level. Results Fifty patients were selected to participate in our study based on our inclusion criteria. They were recruited from the Internal Medicine Department, Gastroenterology Clinic in Al-Demerdash Hospital using a convenient sampling method. Diagnosis of NAFLD was confirmed by laboratory markers: aspartate aminotransferase (AST), alanine aminotransferase (ALT), lipid profile, ultrasound, and FibroScan examination. Analyzing the adiponectin levels showed that besides its significant correlation with body mass index (BMI), hypertension, diabetes mellitus, and dyslipidemia, it was significantly lower in the high-grade fibrosis group compared to the low-grade fibrosis group with a P-value of (0.000) and a cutoff value for stage 3/4 fibrosis of about 2.31 μg/ml which marked a promising hope of adiponectin being of protective value against liver fibrosis. Conclusion 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.

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

QJM ◽

10.1093/qjmed/hcab100.054 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Tarek Mohammed Youssef ◽

Manal Sabry Mohamed ◽

Ahmed El-Metwally Ahmed ◽

Esraa Ebrahim Abdullah

Keyword(s):

Diabetes Mellitus ◽

Liver Disease ◽

Liver Fibrosis ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Liver Diseases ◽

Adiponectin Level ◽

Chronic Liver ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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.

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New opportunities for the correction of type 2 diabetes mellitus in patients with liver diseases

Лечащий врач ◽

10.51793/os.2021.24.12.004 ◽

2021 ◽

Author(s):

Л.Ю. Моргунов ◽

Х.С. Мамедгусейнов

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Liver Diseases ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Заболевания печени у пациентов с сахарным диабетом 2 типа встречаются с большей частотой, чем в общей популяции. Сахарный диабет 2-го типа оказывает негативное влияние на состояние печени, нарушая обмен белков, аминокислот, жиров и других веществ в гепатоцитах, что ведет к развитию ее хронических заболеваний. Сочетание патологии печени и сахарного диабета является прогностическим фактором осложнений и летального исхода. Ингибиторы натрий-глюкозного котранспортера 2-го типа (дапаглифлозин, эмпаглифлозин, канаглифлозин) оказывают позитивное влияние на уменьшение степени жирового гепатоза, снижение концентрации печеночных ферментов и активности воспалительного процесса в печени, улучшая гистологическую картину стеатоза и стеатогепатита. Прогрессирование изменений в печени при сахарном диабете 2 типа в виде неалкогольной жировой болезни печени, объединяющей неалкогольный стеатоз и неалкогольный стеатогепатит, имеющих общие механизмы с синдромом инсулинорезистентности, отражает этапы формирования заболеваний печени, приводящие в итоге к развитию ее цирроза. Проведенные исследования указывают на эффективность натрий-глюкозных котранспортеров 2-го типа у пациентов с циррозом печени. У пациентов с неалкогольной жировой болезнью печени и сахарным диабетом 2 типа при лечении ингибиторами натрий-глюкозного котранспортера 2-го типа отмечается улучшение гистопатологических характеристик при проведении биопсии печени. Кроме того, у этих пациентов наблюдалось снижение индекса массы тела, окружности талии, уровня гликемии. У больных сахарным диабетом 2 типа и неалкогольной жировой болезнью печени, подверженных повышенному риску развития цирроза печени, при лечении ингибиторами натрий-глюкозного котранспортера 2-го типа наблюдалось клинически значимое снижение уровня аланинаминотранферазы в сыворотке крови. Препараты хорошо переносятся пациентами с заболеваниями печени, безопасны в применении и могут с успехом использоваться у больных с печеночной недостаточностью. Liver diseases in patients with type 2 diabetes mellitus occur with a higher frequency than in the general population. Type 2 diabetes mellitus has a negative effect on the condition of the liver, disrupting the metabolism of proteins, amino acids, fats and other substances in hepatocytes, which leads to the development of its chronic diseases.The combination of liver pathology and diabetes mellitus is a prognostic factor of complications and death. Type 2 sodium-glucose cotransporter inhibitors (dapagliflozin, empagliflozin, kanagliflozin) have a positive effect on reducing the degree of fatty hepatosis, reducing the concentration of liver enzymes and the activity of the inflammatory process in the liver, improving the histological picture of steatosis and steatohepatitis. The progression of changes in the liver in type 2 diabetes mellitus in the form of nalcohol fatty liver disease, combining non-alcoholic steatosis and non-alcoholic steatohepatitis, which have common mechanisms with insulin resistance syndrome, reflects the stages of formation of liver diseases, resulting in the development of cirrhosis of the liver. The conducted studies indicate the effectiveness of type 2 sodium-glucose transporters in patients with cirrhosis of the liver. In patients with nnon-alcoholic fatty liver disease with type 2 diabetes mellitus, when treated with inhibitors SGLT2, there is an improvement in histopathological characteristics during liver biopsy. In addition, these patients had a decrease in body mass index, waist circumference, and glycemic level. in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease at increased risk of liver cirrhosis, a clinically significant decrease in serum alanine aminotransferase levels was observed during the treatment of inhibitors SGLT2.I шn patients with liver diseases, the drugs are well tolerated, safe to use and can be successfully used in patients with liver failure.

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Liver fibrosis: noninvasive assessment using supersonic shear imaging and FIB4 index in patients with non-alcoholic fatty liver disease

Choonpa Igaku ◽

10.3179/jjmu.jjmu.k.20 ◽

2020 ◽

Vol 47 (6) ◽

pp. 241-248

Author(s):

Hirohito TAKEUCHI ◽

Katsutoshi SUGIMOTO ◽

Hisashi OSHIRO ◽

Kunio IWATSUKA ◽

Shin KONO ◽

...

Keyword(s):

Liver Disease ◽

Liver Fibrosis ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Supersonic Shear Imaging ◽

Noninvasive Assessment ◽

Alcoholic Fatty Liver Disease

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Evaluation the Predictors of Non-Alcoholic Fatty Liver Disease (NAFLD) in Type 2 Diabetes Mellitus (T2DM) Patients

Systematic Reviews in Pharmacy ◽

10.31838/srp.2020.5.58 ◽

2020 ◽

Vol 11 (05) ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Have we learnt all from Improve-It? Part I. Core results and subanalyses on the effects of ezetimibe added to statin therapy related to age, gender and selected chronic diseases (kidney disease, diabetes mellitus and non- alcoholic fatty liver disease)

Current Vascular Pharmacology ◽

10.2174/1570161118999200727224946 ◽

2020 ◽

Vol 18 ◽

Author(s):

Zlatko Fras ◽

Dimitri P. Mikhailidis

Keyword(s):

Diabetes Mellitus ◽

Liver Disease ◽

High Risk ◽

Kidney Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Risk Patients ◽

Very High ◽

Alcoholic Fatty Liver Disease

: IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) was a randomized clini- cal trial (18,144 patients) that evaluated the efficacy of the combination of ezetimibe with simvastatin vs simvastatin mono- therapy in patients with acute coronary syndrome (ACS) and moderately increased low-density lipoprotein cholesterol (LDL-C) levels (of up to 2.6-3.2 mmol/L; 100-120 mg/dL). After 7 years of follow-up, combination therapy resulted in an additional LDL-C decrease [1.8 mmol/L, or 70 mg/dL, within the simvastatin (40 mg/day) monotherapy arm and 1.4 mmol/L, or 53 mg/dL for simvastatin (40 mg/day) + ezetimibe (10 mg/day)] and showed an incremental clinical benefit (composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary re- vascularization (≥30 days after randomization), or nonfatal stroke; hazard ratio (HR) of 0.936, and 95% CI 0.887-0.996, p=0.016). Therefore, for very high cardiovascular risk patients “even lower is even better” regarding LDL-C, independently of the LDL-C reducing strategy. These findings confirm ezetimibe as an option to treat very-high-risk patients who cannot achieve LDL-C targets with statin monotherapy. Additional analyses of the IMPROVE-IT (both prespecified and post-hoc) include specific very-high-risk subgroups of patients (those with previous acute events and/or coronary revascularization, older than 75 years, as well as patients with diabetes mellitus, chronic kidney disease or non-alcoholic fatty liver disease). The data from IMPROVE-IT also provide reassurance regarding longer-term safety and efficacy of the intensification of li- pid-lowering therapy in very-high-risk patients resulting in very low LDL-C levels. We comment on the results of several (sub) analyses of IMPROVE-IT.

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