Ismaiel Abdulrahman, Ciornolutchii Vera, Herrera Thelva Esposito, Ismaiel Mohamed, Leucuta Daniel-Corneliu, Popa Stefan-Lucian, Dumitrascu Dan L
2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Eur J Clin Invest. 2025 Jan;55(1):e14328. doi: 10.1111/eci.14328. Epub 2024 Nov 2.
Adiponectin, a key adipokine, shows promise as a non-invasive biomarker for liver cirrhosis by reflecting inflammation and metabolic changes, but conflicting findings highlight the need for a systematic review and meta-analysis to clarify its role. Our study aimed to evaluate adiponectin levels across various stages of liver cirrhosis, compare them with other chronic liver diseases (CLD) and hepatocellular carcinoma (HCC), and assess its potential as a diagnostic and prognostic biomarker.
Our systematic search was conducted on September 2023 using PubMed, EMBASE and Scopus, searching for observational studies evaluating serum and plasma adiponectin levels in liver cirrhosis. Inclusion and exclusion criteria were applied, and study quality was assessed using the Newcastle-Ottawa Scale. To evaluate the overall effect size, we utilized a random-effects model along with a mean difference (MD) analysis. The principal summary outcome was the MD in adiponectin levels.
We included 16 articles involving 2617 subjects in our qualitative and quantitative synthesis. We found significantly higher adiponectin levels in liver cirrhosis patients (8.181 [95% CI 3.676, 12.686]), especially in Child-Pugh B individuals (13.294 [95% CI 4.955, 21.634]), compared to controls. Child-Pugh A patients did not show significant differences compared to controls. In addition, adiponectin levels were significantly elevated in primary biliary cholangitis (PBC) patients compared to controls (8.669 [95% CI .291, 17.047]), as well as in liver cirrhosis compared to other CLD patients (4.805 [95% CI 1.247, 8.363]), including non-alcoholic fatty liver disease (NAFLD) (8.532 [95% CI 3.422, 13.641]), but not viral hepatitis. No significant MD was observed between liver cirrhosis and HCC patients.
Adiponectin levels are significantly elevated in liver cirrhosis, especially in advanced stages, potentially serving as a biomarker for advanced cirrhosis. Adiponectin also differentiates cirrhosis from other CLD, including NAFLD. However, its role in distinguishing cirrhosis from viral hepatitis and HCC is limited.
脂联素作为一种关键的脂肪因子，通过反映炎症和代谢变化，有望成为肝硬化的一种非侵入性生物标志物，但相互矛盾的研究结果凸显了进行系统综述和荟萃分析以阐明其作用的必要性。我们的研究旨在评估肝硬化各阶段的脂联素水平，将其与其他慢性肝病（CLD）和肝细胞癌（HCC）进行比较，并评估其作为诊断和预后生物标志物的潜力。
我们于2023年9月使用PubMed、EMBASE和Scopus进行了系统检索，搜索评估肝硬化患者血清和血浆脂联素水平的观察性研究。应用了纳入和排除标准，并使用纽卡斯尔-渥太华量表评估研究质量。为了评估总体效应大小，我们采用随机效应模型以及平均差（MD）分析。主要汇总结果是脂联素水平的MD。
我们纳入了16篇文章，涉及2617名受试者进行定性和定量综合分析。我们发现，与对照组相比，肝硬化患者的脂联素水平显著更高（8.181 [95% CI 3.676, 12.686]），尤其是Child-Pugh B级患者（13.294 [95% CI 4.955, 21.634]）。Child-Pugh A级患者与对照组相比未显示出显著差异。此外，与对照组相比，原发性胆汁性胆管炎（PBC）患者的脂联素水平显著升高（8.669 [95% CI.291, 17.047]），与其他CLD患者相比，肝硬化患者的脂联素水平也显著升高（4.805 [95% CI 1.247, 8.363]），包括非酒精性脂肪性肝病（NAFLD）（8.532 [95% CI 3.422, 13.641]），但病毒性肝炎患者未出现这种情况。肝硬化患者与HCC患者之间未观察到显著的MD。
肝硬化患者的脂联素水平显著升高，尤其是在晚期，可能作为晚期肝硬化的生物标志物。脂联素还可将肝硬化与其他CLD（包括NAFLD）区分开来。然而，其在区分肝硬化与病毒性肝炎和HCC方面的作用有限。
