Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. Division of Gastroenterology.
Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. Nutrition and Dietetic Service.
Ann Hepatol. 2018 Mar 1;17(2):286-299. doi: 10.5604/01.3001.0010.8659.
Adiponectin and resistin levels are increased in patients with cirrhosis, but it prognostic significance is unknown. We sought to investigate the factors associated with adiponectin and resistin levels and its clinical significance in patients with cirrhosis.
This was a prospective cohort study that included 122 subjects with cirrhosis who attended an outpatient clinic and were initially evaluated in 2012. Serum adiponectin and resistin levels were measured in samples collected in 2012 (adiponectin and resistin) and 2014 (adiponectin). Thirty healthy subjects served as a control group.
Higher adiponectin (21.59 μ g/mL vs. 12.52 μg/mL, P < 0.001) and resistin levels (3.83 ng/mL vs. 2.66 ng/mL, P < 0.001) were observed among patients with cirrhosis compared to controls. Patients classified as Child-Pugh B/C had higher adiponectin levels in relation to Child-Pugh A patients. At second measurement, adiponectin levels increased significantly in non-transplant patients and decreased in liver transplant recipients. Univariate Cox analysis showed that among patients with alcoholic liver disease, adiponectin levels were associated with lower transplant-free survival (HR = 1.034, 95% CI 1.006 - 1.062, P = 0.016). The transplant-free survival was significantly lower among patients with alcoholic liver disease and adiponectin ≥ 17 μg/mL (26.55 months, 95% CI 21.40-31.70) as compared to those with levels < 17 μg/mL (33.76 months, 95% CI 30.70-36.82) (P = 0.045). No relationship was found between the levels of resistin and survival.
Adiponectin but not resistin levels were associated with intensity of liver dysfunction and worse prognosis in patients with alcoholic liver disease, suggesting a potential as a prognostic biomarker.
脂联素和抵抗素水平在肝硬化患者中升高,但它们的预后意义尚不清楚。我们旨在研究与脂联素和抵抗素水平相关的因素及其在肝硬化患者中的临床意义。
这是一项前瞻性队列研究,纳入了 2012 年在门诊就诊的 122 例肝硬化患者。于 2012 年(脂联素和抵抗素)和 2014 年(脂联素)采集样本测量血清脂联素和抵抗素水平。30 名健康受试者作为对照组。
与对照组相比,肝硬化患者的脂联素(21.59μg/ml 比 12.52μg/ml,P<0.001)和抵抗素水平(3.83ng/ml 比 2.66ng/ml,P<0.001)更高。Child-Pugh B/C 级患者的脂联素水平高于 Child-Pugh A 级患者。在第二次测量时,非肝移植患者的脂联素水平显著升高,而肝移植受者的脂联素水平下降。单因素 Cox 分析显示,在酒精性肝病患者中,脂联素水平与无移植生存率相关(HR=1.034,95%CI 1.006-1.062,P=0.016)。脂联素水平≥17μg/ml 的酒精性肝病患者的无移植生存率明显低于脂联素水平<17μg/ml 的患者(26.55 个月,95%CI 21.40-31.70 与 33.76 个月,95%CI 30.70-36.82;P=0.045)。抵抗素水平与生存率之间无相关性。
脂联素而非抵抗素水平与酒精性肝病患者肝功能损害程度和预后不良相关,提示其可能成为一种预后生物标志物。