Hypoadiponectinemia as a marker of increased cardiovascular risk in patients with non-alcoholic fatty liver disease: correlation with albumin/creatinine ratio

Abstract

Objective: We assessed plasma adiponectin and its correlation with carotid intima-media-thickness (CIMT), as a marker of atherosclerosis, and urine albumin/creatinine ratio (ACR) in patients with non-alcoholic fatty liver disease (NAFLD). Subjects and methods: The study included 100 Egyptian subjects (50 patients with NAFLD with no history of diabetes or hypertension and 50 age and sexmatched normal healthy control subjects). Urine albumin/creatinine ratio (ACR) was assessed in all participants and fasting plasma adiponectin was measured using ELISA technique. Ultrasonography was used to diagnose NAFLD. CIMT was assessed using high-resolution Doppler ultrasonography. Results: Mild albuminuria was detected in patients with NAFLD (mean urine ACR = 42 ± 30 mg/g). Plasma adiponectin was significantly lower and urine ACR and CIMT significantly higher in patients with NAFLD as compared with the control group (P < 0.001 for all). A significant negative correlation was found between plasma adiponectin and both urine ACR and CIMT in patients with NAFLD (P < 0.001 and < 0.05 respectively). A significant positive correlation was also found between CIMT and urine ACR in those patients (P < 0.05). Plasma adiponectin and urine ACR were independent determinants of CIMT in patients with NAFLD (P < 0.01 and < 0.05 respectively). Conclusion: Patients with NAFLD, without diabetes, have an increased risk of atherosclerosis and cardiovascular disease. Hypoadiponectinemia and low-grade albuminuria are important markers of that risk.

Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals

“…1 ). The studies included were conducted in various countries including Algeria [ 31 ], China [ 32 - 39 ], Croatia [ 40 ], Egypt [ 41 , 42 ], Greece [ 43 , 44 ], India [ 45 - 49 ], Iran [ 50 - 57 ], Italy [ 58 - 66 ], Japan [ 67 , 68 ], Malaysia [ 69 , 70 ], Romania [ 71 ], Serbia [ 72 ], South Korea [ 73 - 78 ], Spain [ 79 , 80 ], Taiwan [ 81 ], Turkey [ 82 - 92 ], USA [ 93 , 94 ]. Additionally, one study [ 95 ] was a multicentre study based in Egypt [ 43 ].…”

“…After the removal of 327 duplicated during the title abstract sieve, 768 papers were remained for abstract screening and a final total of 64 studies conducted between 1998 to 2019 were included in the meta-analysis (figure 1). The studies included were conducted in various countries including Algeria 31 , China [32][33][34][35][36][37][38][39] , Croatia 40 , Egypt 41,42 , Greece 43,44 , India [45][46][47][48][49] , Iran [50][51][52][53][54][55][56][57] , Italy [58][59][60][61][62][63][64][65][66] , Japan 67,68 , Malaysia 69,70 , Romania 71 , Serbia 72 , South Korea [73][74][75][76][77][78] , Spain…”

“…A total of 135,602 patients were included in our analysis with 47,322 patients with NAFLD and 88,280 non-NAFLD controls. NAFLD defined by liver biopsy 44,82,84,86,87,90,92 was found in seven studies, and by non-invasive methods, including ultrasonography [31][32][33][34][35][36][37][38][39][40][41][42][43]83,85,86,88,89,91,93 in 57 studies and CT scan 94 in one study. All studies were assessed to have a high (n=46) or moderate (n=18) quality based on the Joanna Briggs Institute Critical Appraisal Checklist assessment tool (supplementary table 2).…”