Korah Tarek E, El-Sayed Sawsan, Elshafie Maathir K, Hammoda Ghada E, Safan Manal A
Tarek E Korah, Department of Internal Medicine, Faculty of Medicine, Menoufiya University, 32511 Menoufiya, Egypt.
World J Hepatol. 2013 Feb 27;5(2):74-81. doi: 10.4254/wjh.v5.i2.74.
To study serum levels of leptin and adiponectin in patients with chronic hepatitis C virus infection genotype-4 (HCV-4) related steatosis and fibrosis.
We prospectively studied 45 untreated men with chronic HCV-4, with proven steatosis (group I, 30 patients), and fibrosis (group II, 15 patients), on liver biopsy. In addition, 15 healthy men (group III), matched for age, and body mass index were included. However, we excluded another five patients with steatohepatitis, and six patients with cirrhosis. We measured total serum leptin and adiponectin levels, as potential predictors for liver steatosis and fibrosis. Also, a correlation between these adipokines and various clinical and laboratory data were evaluated. All subjects were selected from Tropical and Internal medicine departments, Menoufiya University Hospital, Menoufiya, Egypt, during the period from February 2010 to August 2011.
In group I, severity of hepatic steatosis was mild, moderate, and severe, in 19 patients (63.5%), 8 patients (26.5%), and 3 patients (10%), respectively. In contrast, in group II, hepatic fibrosis was found to be in stage 1, 2, and 3, in 6 patients (40%), in 6 patients (40%), and in 3 patients (20%), respectively. On comparing group I with group II, there was a significant decrease in serum adiponectin levels (131.4 ± 7.91 pg/mL vs 436 ± 9.75 pg/mL, P < 0.001), while there was no significant difference between both groups regarding serum leptin levels (34.69 ± 7.69 ng/mL vs 35.17 ± 1.06 ng/mL, P > 0.05). However, in the same group, when compared with group III, there was a significant increase in serum leptin levels (34.69 ± 7.69 ng/mL vs 10.69 ± 0.84 ng/mL, P < 0.001), while there was a significant decrease in serum adiponectin levels (131.4 ± 7.91 pg/mL vs 342.4 ± 44.48 pg/mL, P < 0.001). In contrast, in group II, when compared with group III, there was a significant increase in serum leptin and adiponectin levels (35.17 ± 1.06 ng/mL vs 10.69 ± 0.84 ng/mL, P < 0.001, and 436 ± 9.75 pg /mL vs 342.4 ± 44.48 pg/mL, P < 0.05, respectively), while there was no significant difference between both groups regarding serum creatinine (0.83 ± 0.34 vs 0.89 ± 0.24, P > 0.05). On the other hand, serum leptin was not correlated with serum adiponectin in group I and in group II (r = 0.09, P > 0.05, and r = -0.1, P > 0.05, respectively). However, serum adiponectin was significantly negatively correlated with serum aspartate transaminase in group I, but no correlation detected in group II (r =-0.39, P > 0.05, and r = -0.03, P > 0.05).
In male patients with chronic HCV-4, serum adiponectin levels are elevated in hepatic fibrosis, but decreased in steatosis. Therefore, in contrast to leptin, adiponectin may be used as a non-invasive marker.
研究慢性丙型肝炎病毒4型（HCV-4）感染相关脂肪变性和纤维化患者的血清瘦素和脂联素水平。
我们前瞻性地研究了45例未经治疗的慢性HCV-4男性患者，经肝活检证实有脂肪变性（I组，30例患者）和纤维化（II组，15例患者）。此外，纳入了15名年龄和体重指数相匹配的健康男性（III组）。然而，我们排除了另外5例脂肪性肝炎患者和6例肝硬化患者。我们测量了血清总瘦素和脂联素水平，作为肝脂肪变性和纤维化的潜在预测指标。此外，还评估了这些脂肪因子与各种临床和实验室数据之间的相关性。所有受试者均选自埃及梅努菲亚大学医院热带医学和内科，时间为2010年2月至2011年8月。
在I组中，肝脂肪变性的严重程度分别为轻度、中度和重度，19例患者（63.5%）、8例患者（26.5%）和3例患者（10%）。相比之下，在II组中，肝纤维化分别处于1期、2期和3期，6例患者（40%）、6例患者（40%）和3例患者（20%）。I组与II组相比，血清脂联素水平显著降低（131.4±7.91 pg/mL对436±9.75 pg/mL，P<0.001），而两组血清瘦素水平无显著差异（34.69±7.69 ng/mL对35.17±1.06 ng/mL，P>0.05）。然而，在同一组中，与III组相比，血清瘦素水平显著升高（34.69±7.69 ng/mL对10.69±0.84 ng/mL，P<0.001），而血清脂联素水平显著降低（131.4±7.91 pg/mL对342.4±44.48 pg/mL，P<0.001）。相比之下，在II组中，与III组相比，血清瘦素和脂联素水平显著升高（35.17±1.06 ng/mL对10.69±0.84 ng/mL，P<0.001，以及436±9.75 pg/mL对342.4±44.48 pg/mL，P<0.05），而两组血清肌酐无显著差异（0.83±0.34对0.89±0.24，P>0.05）。另一方面，I组和II组中血清瘦素与血清脂联素均无相关性（r=0.09，P>0.05，以及r=-0.1，P>0.05）。然而，I组中血清脂联素与血清天冬氨酸转氨酶显著负相关，但II组中未检测到相关性（r=-0.39，P>0.05，以及r=-0.03，P>0.05）。
在慢性HCV-4男性患者中，肝纤维化时血清脂联素水平升高，而脂肪变性时降低。因此，与瘦素不同，脂联素可作为一种非侵入性标志物。
