Circulating chemerin levels in metabolic-associated fatty liver disease: a systematic review and meta-analysis

Abstract

Background and objectives Chemerin is a brand-new adipokine that has been linked to both inflammation and metabolic dysfunction. Even though a rising number of studies have connected chemerin to metabolic-associated fatty liver disease (MAFLD), formerly referred to as non-alcoholic fatty liver disease (NAFLD), this association has been controversial. Methods A comprehensive literature search was undertaken up to February 1, 2022, in the PubMed, Embase, Web of Science, CNKI, WANFANG, and CBM library databases. Circulating chemerin levels were obtained and summarized using the standardized mean difference (SMD) and 95% confidence interval (CI). Subgroup and meta-regression analyses were conducted to examine the possibility of heterogeneity. Results A total of 17 studies involving 2580 participants (1584 MAFLD patients and 996 controls) evaluated circulating chemerin levels in patients with MAFLD. The present study showed that higher chemerin levels were found in patients with MAFLD (SMD: 1.32; 95% CI: 0.29, 2.35) and nonalcoholic fatty liver (NAFL) (SMD: 0.75; 95% CI: 0.01, 1.50) compared to controls. However, circulating chemerin levels did not differ significantly in the following comparisons: nonalcoholic steatohepatitis (NASH) patients and controls (SMD: 0.75; 95% CI: -0.52, 2.03); NASH patients and NAFL patients (SMD: 0.16; 95% CI: -0.39, 0.70); moderate to severe steatosis and mild steatosis (SMD: 0.55; 95% CI: -0.59, 1.69); present liver fibrosis and absent liver fibrosis (SMD: 0.66; 95% CI: -0.42, 1.74); present lobular inflammation and absent lobular inflammation (SMD: 0.45; 95% CI: -0.53, 1.42); and present portal inflammation and absent portal inflammation (SMD: 1.92; 95% CI: -0.85, 4.69). Conclusions Chemerin levels were considerably greater in patients with MAFLD than in controls, despite the fact that they were not significantly linked to different liver tissue lesions of MAFLD. In different subtypes of MAFLD, in comparison to healthy controls, the chemerin levels of NAFL patients were higher, whereas, there was no obvious difference in chemerin levels between NASH patients and controls. It is possible that chemerin will be used as a biomarker in the future to track the development and progression of MAFLD.

Serum Chemerin Is Decreased by Roux-en-Y Gastric Bypass and Low Calorie-Formula Diet in Obese Individuals

“…Circulating chemerin has been characterized as a risk factor for NAFLD/MASLD [29] and has been suggested as a potential non-invasive biomarker [30]. We recently reported the correlation of body fat loss and improvement of liver fibrosis risk during obesity therapy [19].…”

The regulatory role of metabolic organ-secreted factors in the nonalcoholic fatty liver disease and cardiovascular disease

“…Chemerin is mainly secreted by adipocytes and hepatocytes in an inactive form and activated by extracellular C-terminal protease cleavage, which acts as a ligand to bind to chemokine-like receptor 1, G protein-coupled receptors and chemokine (CC motif) receptor-like 2 ( 52 ). Chemerin is strongly related to a variety of physiological or pathological activities, such as innate immunity, inflammation, fibrosis, endothelial dysfunction, angiogenesis, oxidative stress, IR, and metabolic disorders ( 35 , 53 ). Epidemiological studies reported that serum chemerin levels were generally higher in NAFLD or SS patients relative to controls, but there was no evident difference in circulating chemerin levels between NASH and healthy controls, and between NASH and SS patients ( 53 ).…”

“…Chemerin is strongly related to a variety of physiological or pathological activities, such as innate immunity, inflammation, fibrosis, endothelial dysfunction, angiogenesis, oxidative stress, IR, and metabolic disorders ( 35 , 53 ). Epidemiological studies reported that serum chemerin levels were generally higher in NAFLD or SS patients relative to controls, but there was no evident difference in circulating chemerin levels between NASH and healthy controls, and between NASH and SS patients ( 53 ). Of note, although the data on hepatic chemerin mRNA expression in NASH patients were inconsistent, most studies indicated that hepatic chemerin mRNA expression was closely correlated with inflammation and hepatic fibrosis ( 54 ).…”

Adipokines in Non-Alcoholic Fatty Liver Disease: Are We on the Road toward New Biomarkers and Therapeutic Targets?

“…In fact, elevated serum chemerin levels were identified as a risk factor for NAFLD development in T2DM patients [ 119 ] and were pointed out as a novel non-invasive serum marker predicting liver steatosis in obese children [ 120 ]. A recent meta-analysis [ 121 ] further explored the correlations between serum chemerin levels and NAFLD (steatosis and/or NASH) and its specific hepatic histologic lesions (liver steatosis, lobular and portal inflammation, and fibrosis). Overall, circulating chemerin levels were consistently higher in patients with NAFLD and steatosis compared to controls, although no significant difference was verified between NASH patients and controls.…”

“…Overall, circulating chemerin levels were consistently higher in patients with NAFLD and steatosis compared to controls, although no significant difference was verified between NASH patients and controls. Moreover, data on serum chemerin levels and specific liver lesions are inconsistent, and no correlations were verified [ 81 , 121 ].…”