Is There a Link between Basal Metabolic Rate, Spleen Volume and Hepatic Growth Factor Levels in Patients with Obesity-Related NAFLD?

Abstract

Background: Recent pieces of research point to a link between basal metabolic rate (BMR) and non-alcoholic fatty liver disease (NAFLD) or hepatic steatosis (HS). The spleen in obese patients is associated with the cardiovascular system. Enlargement of the spleen is suggestive of nonalcoholic steatohepatitis (NASH). Patients with NASH present an increase in growth factor (HGF) as well as those with advanced heart failure. Interleukin-16 and interleukin-12p40 levels were found to correlate significantly with BMI, and waist circumference. Aim: We tried to find a relationship between BMR, spleen length and HGF. Methods: We analysed retrospective data from 80 obese patients with NAFLD. We evaluated indices of indirect calorimetry by the bioimpendance analysis; carotid intima-media thickness (IMT), spleen length (SLD) and HS by ultrasonography; serum HGF, IL-16, IL-12p40 and IL-6 concentrations by a magnetic bead-based multiplex immunoassays and the severity of NAFLD by BARD score > 2. Results: HGF levels of the obese were higher than those of controls, p < 0.001. At linear regression, BMR was foreseen by spleen length (p < 0.001), which was predicted by HGF (p = 0.04). BMR was predicted by IL-16 (p = 0.005), which predicted HGF, p = 0.034. Only fat mass, among other factors, predicted early atherosclerosis, p = 0.017; IL-12p40 did not predict IMT, HGF and BMR (p = 0.57, 0.09 and 0.59, respectively). The BARD score > 2 was negatively predicted by BMR and FFM (p =0.032 and 0.031, respectively), at the logistic regression. Interesting findings at the extended regression (mediation effect) were: IL-16 was likely causal in predicting BMR by HGF levels; HGF was influential in predicting BMR by SLD level. HS was predicted by SLD in males (p = 0.014), of advanced age (p < 0.001) and by BMR (p < 0.001). IL-6 concentrations, but not BMR were influential in the prediction of HS by SLD. Conclusion: These data reinforce the concept that the immune system is a sensor of the metabolic state, showing a link between HGF levels and BMR, which is mediated by IL-16 (cytokine inducing a cascade of inflammatory factors), and ascertaining the influential effect of the spleen, as main immune organ.

Association between serum interleukin (IL)-12 level and severity of non-alcoholic fatty liver disease (NAFLD)

“…A moderate positive correlation was observed between serum IL-12 level and BARD score with sufficient accuracy in cut-off at more than 49.5 pg/mL to predict high BARD score. This study result is discordant to another study by Tarantino et al [21], which IL-12 cannot predict hepatic steatosis, but the severity of hepatic steatosis in this study was determined by using ultrasound. As per our patient's characteristics has significant differences in IMT; we used the BARD score to determine if IL-12 could predict severity, as ultrasound can be biased in patients with abdominal fat thickness [22] and the BARD score had high sensitivity [23].…”

Patients with Asthma and Chronic Obstructive Pulmonary Disease (COPD) have increased levels of plasma inflammatory mediators upregulated in severe COVID-19

“…In this setting, our data support that HGF and OPG could be involved in severe COVID-19 by affecting pathways implicated in coagulopathy and thrombosis [41-43]. Since HGF have been reported increased in patients with rheumatic diseases [44] as well as in patients with insulin resistance-diabetes [45], obesity [46], and diabetic kidney disease [47], further studies are needed to establish if it is elevated in severe COVID-19 as a pre-existing condition reflecting the presence of the comorbidity, or if increases during the infection and has a role in the pathophysiology this condition.…”

Nonalcoholic Fatty Liver Disease: A Challenge from Mechanisms to Therapy

“…The volume of spleen did not change [38], casting doubts on the role of lifestyle on immune processes. In contrast, up to date data reinforce the concept that the immune system is a sensor of the metabolic state, showing a link between hepatic growth factor levels and basal metabolic rate, which is mediated by IL-16 (cytokine promoting important inflammatory pathways), and pointing out the influence of the spleen, as a main immune organ [39]. To test whether hepatic and splenic metabolic activities were linked, the glucose uptake rate per unit tracer distribution volume, i.e., metabolic rate of glucose (MRglu), evaluated by dynamic PET, was performed.…”