Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
PLoS One. 2011;6(11):e26840. doi: 10.1371/journal.pone.0026840. Epub 2011 Nov 14.
Adiponectin is shown to be inversely associated with development and progression of various cancers. We evaluated whether adiponectin level was associated with the prevalence and histological grade of hepatocellular carcinoma (HCC), and liver fibrosis in patients with hepatitis C virus (HCV) infection.
A case-control study was conducted on 97 HCC patients (cases) and 97 patients (controls) matched for sex, Child-Pugh grade and platelet count in patients with HCV infection. The serum total and high molecular weight (HMW) adiponectin levels were measured by enzyme-linked immunosorbent assays and examined in their association with the prevalence of HCC. In addition, the relationship between these adiponectin levels and body mass index (BMI), progression of liver fibrosis, and histological grade of HCC was also evaluated. Liver fibrosis was assessed using the aspartate aminotransferase to platelet ratio index (APRI).
There were no significant differences in the serum total and HMW adiponectin levels between cases and controls. Moreover, there were no inverse associations between serum total and HMW adiponectin levels and BMI in both cases and controls. On the other hand, serum total and HMW adiponectin levels are positively correlated with APRI in both cases (r = 0.491, P<0.001 and r = 0.485, P<0.001, respectively) and controls (r = 0.482, P<0.001 and r = 0.476, P<0.001, respectively). Interestingly, lower serum total (OR 11.76, 95% CI: 2.97-46.66 [P<0.001]) and HMW (OR 10.24, CI: 2.80-37.40 [P<0.001] adiponectin levels were independent risk factors of worse histological grade of HCC.
Our results suggested that serum total and HMW adiponectin levels were predictors of liver fibrosis, but not prevalence of HCC in patients with HCV infection. Moreover, low these adiponectin levels were significantly associated with worse histological grades.
脂联素与各种癌症的发生和发展呈负相关。我们评估了脂联素水平是否与丙型肝炎病毒(HCV)感染患者的肝癌(HCC)患病率和组织学分级以及肝纤维化有关。
对 97 例 HCC 患者(病例)和 97 例性别、Child-Pugh 分级和血小板计数匹配的 HCV 感染患者(对照组)进行病例对照研究。采用酶联免疫吸附试验测定血清总脂联素和高分子量(HMW)脂联素水平,并观察其与 HCC 患病率的关系。此外,还评估了这些脂联素水平与体重指数(BMI)、肝纤维化进展和 HCC 组织学分级的关系。采用天门冬氨酸氨基转移酶血小板比值指数(APRI)评估肝纤维化。
病例组和对照组血清总脂联素和 HMW 脂联素水平无显著性差异。此外,病例组和对照组血清总脂联素和 HMW 脂联素水平与 BMI 之间均无负相关关系。另一方面,血清总脂联素和 HMW 脂联素水平与病例组和对照组的 APRI 呈正相关(r=0.491,P<0.001 和 r=0.485,P<0.001)。有趣的是,较低的血清总脂联素(OR 11.76,95%CI:2.97-46.66[P<0.001])和 HMW 脂联素(OR 10.24,CI:2.80-37.40[P<0.001])是 HCC 组织学分级较差的独立危险因素。
我们的结果表明,血清总脂联素和 HMW 脂联素水平是 HCV 感染患者肝纤维化的预测因子,但不是 HCC 患病率的预测因子。此外,这些脂联素水平较低与组织学分级较差显著相关。