Circulating adiponectin reflects severity of liver disease but not insulin sensitivity in liver cirrhosis

Abstract

. Background. The adipocytokine adiponectin has been proposed to play important roles in the regulation of energy homeostasis, insulin sensitivity and shows anti‐inflammatory properties. Aim. In this study we investigated the role of circulating adiponectin in different chronic liver diseases, its regulation by systemic anti‐tumour necrosis factor (TNF)‐α treatment and its hepatic metabolism. Patients and methods. Plasma adiponectin levels were determined in 87 patients with liver cirrhosis of different aetiologies, seven patients with alcoholic steatohepatitis undergoing systemic anti‐TNF‐α treatment, in 11 patients with liver cirrhosis receiving transjugular intrahepatic portosystemic shunt implantation and in 21 healthy controls. Results. Adiponectin levels were significantly higher in all subjects with liver cirrhosis of different aetiologies when compared with healthy controls and increased dependent on Child‐Pugh classification. In subjects with alcoholic steatohepatitis, systemic anti‐TNF‐α treatment caused a significant decrease in circulating adiponectin. Adiponectin concentrations were similar in portal, hepatic and peripheral veins. No correlation between adiponectin levels and insulin resistance was found in any patient group. Conclusions. Our data suggest that circulating adiponectin is increased in liver cirrhosis independent of the aetiology of liver disease. We suggest that high adiponectin levels in chronic liver disease might reflect one of the body's anti‐inflammatory mechanisms in chronic liver diseases.

High serum adiponectin correlates with advanced liver disease in patients with chronic hepatitis B virus infection

“…To our knowledge, only few studies examined the role of adiponectin in patients with chronic HBV infection [28,29,31]. We have examined the change of serum adiponectin levels before and after interferon a therapy in 10 patients with chronic HBV infection and found that the adiponectin levels did not correlate with the response to interferon therapy (responders versus nonresponders: 17.7 ± 4.1 vs. 9.2 ± 1.0 lg/ml, P = 0.10) [31].…”

“…These results contradict previous concept of the inverse relationship between degree of insulin resistance and adiponectin levels and prompted us to conduct further studies. Kaser et al [29] evaluated serum adiponectin level in 87 patients with cirrhosis of different etiologies, including HBV-related cirrhosis (n = 8) and 21 healthy controls. They found that serum adiponectin level increased in patients with cirrhosis independent of the etiology of liver disease [29].…”

“…Kaser et al [29] evaluated serum adiponectin level in 87 patients with cirrhosis of different etiologies, including HBV-related cirrhosis (n = 8) and 21 healthy controls. They found that serum adiponectin level increased in patients with cirrhosis independent of the etiology of liver disease [29]. Hui et al [28] recently assessed serum adiponectin level in 100 patients with biopsy-proven different fibrosis stages of chronic HBV infection and 38 patients with paired liver biopsies before and after antiviral treatment.…”

“…Consistently, serum adiponectin levels tend to be lower in patients with elevated serum alanine aminotransferase (ALT) values and those with fibrosis [23,26,27]. Paradoxically, serum adiponectin level seemed higher in patients with impaired liver function such as those with advanced fibrosis or cirrhosis, possibly because of decreased hepatic extraction of adiponectin [28][29][30].…”

Plasma Adipokines and Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Virus–Infected Carriers: A Prospective Study in Taiwan

“…However, cross-sectional studies showed the opposite results of significantly elevated circulating adiponectin levels in cirrhosis patients of different etiologies when compared with healthy controls (23,24). Furthermore, adiponectin was found to be significantly higher in patients with more advanced chronic liver disease, leading to the speculation that adiponectin might be an indicator of liver disease severity (24).…”