Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention & Control, Chennai, India.
Indian J Med Res. 2010 Sep;132:271-7.
BACKGROUND & OBJECTIVES: Association between adiponectin and non-alcoholic fatty liver disease (NAFLD) has been reported in west. Studies in Indian population are lacking. This study was undertaken to assess the association of hypoadiponectinemia with NAFLD in Asian Indians.
In this cross-sectional study, subjects were randomly selected from Phase 5 of the Chennai Urban Rural Epidemiology Study (CURES), an epidemiological study based on a representative population of Chennai in south India. One hundred twenty one subjects without NAFLD and 72 subjects with NAFLD were selected. NAFLD was diagnosed by ultrasonography. Serum adiponectin levels were measured using radioimmunoassay. Insulin resistance was calculated using Homeostasis Assessment model (HOMA-IR).
Serum adiponectin values were significantly lower in subjects with NAFLD compared to those without [5.6 μg/ml (95% Confidence Interval (CI) 5.0 - 6.3 μg/ml] vs 7.4 μg/ml (95% CI: 6.7 - 8.1 μg/ml, P<0.01). Adiponectin levels decreased with increasing severity of NAFLD. Subjects with moderate to severe steatosis had significantly lower adiponectin levels (5.1μg/ml, 95% CI: 4.1- 6.4 μg/ml) compared to subjects with mild steatosis (5.9 μg/ml, 95% CI: 5.0 - 6.9 μg/ml; P<0.001) and subjects without NAFLD (7.3 μg/ml, 95% CI: 6.6 - 8.0 μg/ml; P<0.01). Multiple logistic regression analysis revealed adiponectin to be negatively associated with NAFLD [Odds Ratio (OR): 0.865, 95% Confidence Interval (CI): 0.792- 0.944, P=0.001]. This remained statistically significant even after adjusting for confounding factors age, gender, body mass index, insulin resistance, waist circumference, total cholesterol, triglycerides and glucose intolerance (OR: 0.873, 95% CI: 0.793 - 0.961; P=0.005).
INTERPRETATION & CONCLUSION: NAFLD is associated with lower serum adiponectin levels independent of conventional cardiovascular risk factors in Asian Indians known to have high prevalence of diabetes and coronary artery disease.
在西方人群中，脂联素与非酒精性脂肪性肝病（NAFLD）之间存在关联。然而，印度人群的相关研究较为缺乏。本研究旨在评估亚洲人群中低脂联素血症与 NAFLD 之间的相关性。
本横断面研究从印度南部钦奈城市农村流行病学研究（CURES）的第 5 阶段中随机选择受试者，该研究是一项基于钦奈代表性人群的流行病学研究。选择了 121 名无 NAFLD 受试者和 72 名有 NAFLD 受试者。通过超声检查诊断 NAFLD。使用放射免疫分析法测定血清脂联素水平。采用稳态模型评估胰岛素抵抗（HOMA-IR）。
与无 NAFLD 受试者相比，有 NAFLD 受试者的血清脂联素值明显降低[5.6μg/ml（95%置信区间（CI）：5.0-6.3μg/ml）vs. 7.4μg/ml（95% CI：6.7-8.1μg/ml），P<0.01]。随着 NAFLD 严重程度的增加，脂联素水平逐渐降低。中重度脂肪变性患者的脂联素水平明显低于轻度脂肪变性患者（5.1μg/ml，95% CI：4.1-6.4μg/ml）和无 NAFLD 受试者（7.3μg/ml，95% CI：6.6-8.0μg/ml），差异均具有统计学意义（P<0.001）。多因素 logistic 回归分析显示，脂联素与 NAFLD 呈负相关[比值比（OR）：0.865，95%置信区间（CI）：0.792-0.944，P=0.001]。即使在校正年龄、性别、体重指数、胰岛素抵抗、腰围、总胆固醇、甘油三酯和葡萄糖耐量异常等混杂因素后，该相关性仍具有统计学意义（OR：0.873，95% CI：0.793-0.961；P=0.005）。
在已知糖尿病和冠状动脉疾病患病率较高的亚洲人群中，NAFLD 与血清脂联素水平降低有关，且这种相关性独立于传统心血管危险因素。
