Correlation Between Nonalcoholic Fatty Liver Disease Features and Levels of Adipokines and Inflammatory Cytokines Among Morbidly Obese Individuals

Abstract

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the commonest hepatopathy worldwide. OBJECTIVE: To investigate the correlations between NAFLD histopathological features and the levels of adipokines (adiponectin, leptin, and resistin) and circulating inflammatory markers (interleukin-6 [IL-6], interleukin-8 [IL-8], tumor necrosis factor alpha [TNF-α], and C-reactive protein [CRP]). METHODS: This is an exploratory cross-sectional study, which enrolled 19 women with obesity who underwent bariatric surgery. Biochemical characteristics evaluated included the levels of adiponectin, leptin, resistin, IL-6, IL-8, TNF-α, and CRP. NAFLD was assessed through histological examination of liver biopsies carried out during the surgical procedures. RESULTS: The mean age of the study group was 37.3±8.2 years old; mean BMI was 36.2±2.5 kg/m2. Among individuals with liver fibrosis, the levels of IL-8 were significantly higher (24.4 ± 9.7 versus 12.7 ± 6.6; P=0.016726). The intensity of fibrosis presented a significant negative correlation with the levels of adiponectin (R= -0.49379; P=0.03166); i.e. the higher the levels of adiponectin, the lower the intensity of fibrosis. The intensity of steatohepatitis presented a significant negative correlation with the levels of adiponectin (R= -0.562321; P=0.01221); this means that the higher the levels of adiponectin, the lower the intensity of steatohepatitis. CONCLUSION: Adiponectin levels were inversely correlated with the severity of fibrosis and steatohepatitis, whereas IL-8 levels were higher in individuals with liver fibrosis among individuals with obesity and NAFLD undergoing bariatric surgery. The use of these markers to assess NAFLD may bring significant information within similar populations.

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“…The level of adiponectin was lowered in class A patients and increased in patients with more severe course and correlated with severity of the disease and MELD score. Considering the hepatoprotective effect of adiponectin, some scientists believe that its elevated level reflects the anti-inflammatory response to liver damage, which depends on the severity of the disease [8,9].…”

“…Some adipocytes are proinflammatory cytokines, some are involved in the metabolism of glucose and lipids, and others affect the complement system and vascular hemostasis [6,7]. Adiponectin, leptin and resistin are the most described adipokines whose role in the development and progression of diseases accompanied by lipid disorders is ambiguous and is still the subject of scientific research [8,9,10]. the purpose of the research was to study the changes in adipocytokines in patients with ALD associated with NAFLD depending on the stage of decompensation.…”

Indicadores antropométricos de adiposidade abdominal na doença hepática gordurosa não alcoólica

“…A doença hepática gordurosa não alcoólica (DHGNA) é consequência do excesso do aporte de ácidos graxos para o fígado, devido à lipólise excessiva. Tem sido cada vez mais diagnosticada em todo o mundo e atualmente é reconhecida como fonte de preocupação na saúde pública mundial (BALTIERI et al, 2018;CASTRO et al, 2019). Nos últimos anos esta afecção ganhou importância epidemiológica por representar uma das principais causas de hepatopatia crônica e por se manifestar em diferentes faixas etárias, sexos e grupos étnicos (CAZZO et al, 2016;ANDRADE et al, 2016).…”

“…A fisiopatologia da esteatose hepática não alcoólica é multifatorial e envolve diversos mecanismos relacionados, como resistência à insulina (RI), desequilíbrio de mediadores inflamatórios, lipotoxicidade e endotoxemia, no entanto, a sua patogenia ainda não está totalmente esclarecida (BALTIERI et al, 2018). Uma das teorias aceitas cientificamente afirma que o dano no tecido hepático é iniciado pelo acúmulo de triglicerídeos nos hepatócitos, como um fator sensibilizante para o dano secundário causado por disfunção mitocondrial, estresse oxidativo e mediadores inflamatórios que resultam em uma inflamação crônica no fígado.…”

“…O tecido adiposo secreta compostos metabolicamente ativos, chamados de adipocinas, como a adiponectina, leptina e IL-6. A adiponectina, hormônio com propriedades anti-inflamatórias, é produzida pelos adipócitos em quantidade inversamente proporcional à porcentagem de gordura corpórea dos indivíduos, portanto, nos obesos são encontrados baixos níveis dessa citocina (BALTIERI et al, 2018).…”