D'Incao Rafael Bergesch, Tovo Cristiane Valle, Mattevi Vanessa Suñé, Borges Diego Olschowsky, Ulbrich Jane Maria, Coral Gabriela Perdomo, Ramos Mauricio Jacques, Meinhardt Nelson Guardiola
Medicine at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua São Manoel, 95 / 403; Bairro Rio Branco, Porto Alegre, CEP 90620-110, Brazil.
Department and at Post Graduation Program, Hepatology at UFCSPA, Porto Alegre, Brazil.
Obes Surg. 2017 Aug;27(8):2151-2158. doi: 10.1007/s11695-017-2627-4.
Obesity is a worldwide prevalent disease and is an underlying factor of non-alcoholic fatty liver disease (NAFLD). It has been understood as a chronic inflammatory state, being associated with the production of adipokines. The aim of this study was to analyze the levels of adipokines in the serum, visceral, and subcutaneous fat and to compare them with hepatic histopathology in morbidly obese patients.
This is a cross-sectional observational study, which analyzed the findings of liver biopsy in patients undergoing bariatric surgery and who had performed analysis of adipokines mRNA expression (adiponectin-ADIPOQ, leptin-LEP, and resistin-RETN) in subcutaneous and visceral adipose tissue and circulating adipokines in serum. Liver biopsies performed were evaluated according to Kleiner criteria.
The study analyzed 25 patients undergoing bariatric surgery. The sample was composed exclusively of women. There was a predominance of NAFLD, with 21 patients (84%) with intrahepatic fat accumulation. Twelve patients presented non-alcoholic steatohepatitis (NASH). Glycated hemoglobin levels (HbA1c) were elevated in NASH patients. ADIPOQ levels were directly correlated with high-density lipoprotein (HDL) cholesterol levels and inversely correlated with triglycerides and total cholesterol. LEP levels showed an inverse relationship with the degree of steatosis, and RETN levels showed an inverse relationship with fibrosis stages.
Serum LEP levels were reduced in the presence of increased levels of intrahepatic fat, and serum levels of RETN were diminished in the presence of NASH. HbA1c levels were higher in the presence of NASH, indirectly reflecting insulin resistance. Moreover, ADIPOQ levels were related to blood lipid profile.
肥胖是一种全球流行的疾病，是非酒精性脂肪性肝病（NAFLD）的潜在因素。它被认为是一种慢性炎症状态，与脂肪因子的产生有关。本研究的目的是分析病态肥胖患者血清、内脏和皮下脂肪中脂肪因子的水平，并将其与肝脏组织病理学进行比较。
这是一项横断面观察性研究，分析了接受减肥手术患者的肝活检结果，这些患者还对皮下和内脏脂肪组织中的脂肪因子mRNA表达（脂联素-ADIPOQ、瘦素-LEP和抵抗素-RETN）以及血清中循环脂肪因子进行了分析。根据克莱纳标准对所进行的肝活检进行评估。
该研究分析了25例接受减肥手术的患者。样本仅由女性组成。NAFLD占主导，21例患者（84%）有肝内脂肪堆积。12例患者出现非酒精性脂肪性肝炎（NASH）。NASH患者的糖化血红蛋白水平（HbA1c）升高。ADIPOQ水平与高密度脂蛋白（HDL）胆固醇水平直接相关，与甘油三酯和总胆固醇呈负相关。LEP水平与脂肪变性程度呈负相关，RETN水平与纤维化阶段呈负相关。
肝内脂肪水平升高时血清LEP水平降低，NASH时血清RETN水平降低。NASH时HbA1c水平较高，间接反映胰岛素抵抗。此外，ADIPOQ水平与血脂谱有关。
