Serum Adipokines in Patients with Non-alcoholic Fatty Liver Disease - Is there a Role for Predicting the Severity of Liver Disease?

Introduction: Non-alcoholic fatty liver disease (NAFLD) is considered to be among the most common liver diseases world-wide. NAFLD encompasses a broad spectrum of pathological conditions ranging from Simple Steatosis (SS) to steatohepatitis (NASH), fibrosis and finally even cirrhosis. Adiponectin (A) has been associated with inhibition of fibrogenesis and liver protection while Leptin (L) contributes to fibrogenesis in various chronic liver diseases, notably in NASH. The aim of work: To determine the validity of serum adipokines including leptin, adiponectin, and A/L ratio to act as potential markers for NAFLD and to discriminate NASH from SS. Patients and methods: Eighty four patients who have bright liver on abdominal ultrasonography and 28 healthy individuals served as control group. Serum Leptin and Adiponectin were estimated by ELISA technique. Liver biopsy was done for 46 patients and according to histopathological examination they were divided into 21 patients with SS and 25 patients with NASH. Results: The serum concentration of adiponectin was significantly lower in NASH than SS group (P<0.001). There was no significant difference between serum concentration of leptin in both groups (P=0.4). A/L ratio in NASH group was significantly lower than SS group (P<0.001). Adiponectin was negatively correlated with BMI, total cholesterol and LDL-C in both groups. A/L ratio in NASH group was significantly positively correlated with adiponectin (P<0.001) while it was significantly negatively correlated with leptin (P<0.001). In SS group A/L ratio was significantly negatively correlated with leptin (r=-0.863, P<0.001). Conclusion: In patients with NAFLD, the serum adiponectin and A/L ratio can discriminate simple steatosis from NASH and predict the severity of liver injury.