Adipokine Levels Versus Hepatic Histopathology in Bariatric Surgery Patients

• Published in: Obesity surgery 2017-08, Vol.27 (8), p.2151-2158
• Main Authors: D’Incao, Rafael Bergesch, Tovo, Cristiane Valle, Mattevi, Vanessa Suñé, Borges, Diego Olschowsky, Ulbrich, Jane Maria, Coral, Gabriela Perdomo, Ramos, Mauricio Jacques, Meinhardt, Nelson Guardiola
• Format: Article
• Language: English
• Subjects: Adipokines - blood; Adult; Bariatric Surgery; Biopsy; Cross-Sectional Studies; Cytokines; Female; Gastrointestinal surgery; Histopathology; Humans; Insulin resistance; Intra-Abdominal Fat - chemistry; Intra-Abdominal Fat - pathology; Liver - chemistry; Liver - pathology; Liver diseases; Medicine; Medicine & Public Health; Middle Aged; Non-alcoholic Fatty Liver Disease - etiology; Non-alcoholic Fatty Liver Disease - pathology; Obesity; Obesity, Morbid - blood; Obesity, Morbid - complications; Obesity, Morbid - pathology; Obesity, Morbid - surgery; Original Contributions; Subcutaneous Fat - chemistry; Subcutaneous Fat - pathology; Surgery
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-017-2627-4

Background Obesity is a worldwide prevalent disease and is an underlying factor of non-alcoholic fatty liver disease (NAFLD). It has been understood as a chronic inflammatory state, being associated with the production of adipokines. The aim of this study was to analyze the levels of adipokines in the serum, visceral, and subcutaneous fat and to compare them with hepatic histopathology in morbidly obese patients. Methods This is a cross-sectional observational study, which analyzed the findings of liver biopsy in patients undergoing bariatric surgery and who had performed analysis of adipokines mRNA expression (adiponectin—ADIPOQ, leptin—LEP, and resistin—RETN) in subcutaneous and visceral adipose tissue and circulating adipokines in serum. Liver biopsies performed were evaluated according to Kleiner criteria. Results The study analyzed 25 patients undergoing bariatric surgery. The sample was composed exclusively of women. There was a predominance of NAFLD, with 21 patients (84%) with intrahepatic fat accumulation. Twelve patients presented non-alcoholic steatohepatitis (NASH). Glycated hemoglobin levels (HbA1c) were elevated in NASH patients. ADIPOQ levels were directly correlated with high-density lipoprotein (HDL) cholesterol levels and inversely correlated with triglycerides and total cholesterol. LEP levels showed an inverse relationship with the degree of steatosis, and RETN levels showed an inverse relationship with fibrosis stages. Conclusion Serum LEP levels were reduced in the presence of increased levels of intrahepatic fat, and serum levels of RETN were diminished in the presence of NASH. HbA1c levels were higher in the presence of NASH, indirectly reflecting insulin resistance. Moreover, ADIPOQ levels were related to blood lipid profile.