Adiponectin: A New Independent Predictor of Liver Steatosis and Response to IFN-á Treatment in Chron

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American Journal of Gastroenterology 103 (3) , 605-614

doi:10.1111/j.1572-0241.2007.01729.x

Abstract

Adiponectin: A New Independent Predictor of Liver Steatosis and Response to

IFN-á Treatment in Chronic Hepatitis C

Theodoros A. Zografos, M.D.11Department of Medicine (Research Laboratory of

Internal Medicine, Christos Liaskos, M.D., Ph.D.11Department of Medicine

(Research Laboratory of Internal Medicine, Eirini I. Rigopoulou, M.D.,

Ph.D.22Academic Liver Unit, Elias Togousidis, Ph.D.11Department of Medicine

(Research Laboratory of Internal Medicine, Kostantinos Makaritsis, M.D.,

Ph.D.22Academic Liver Unit, Anastasios Germenis, M.D., Ph.D.33Laboratory of

Immunology and Histocombatibility, Medical School, University of Thessaly,

Larissa, Greece, and N. Dalekos, M.D., Ph.D.1,21Department of Medicine

(Research Laboratory of Internal Medicine2Academic Liver Unit1Department of

Medicine (Research Laboratory of Internal Medicine and 2Academic Liver Unit) and

3Laboratory of Immunology and Histocombatibility, Medical School, University of

Thessaly, Larissa, Greece

Reprint requests and correspondence: N. Dalekos, M.D., Ph.D., Department

of Medicine, Academic Liver Unit, Medical School, University of Thessaly,

Papakiriazi 22 Str, 41222 Larissa, Greece.

(Am J Gastroenterol 2008;103:605-614)

Abstract

OBJECTIVES: To compare serum adiponectin and tumor necrosis factor (TNF)-á among

patients with viral liver diseases; to investigate associations of serum

adiponectin and TNF-á with histological or viral characteristics of chronic

hepatitis C (CHC); to investigate adiponectin and TNF-á alterations during

interferon (IFN)-á treatment; and to assess the relationship between serum

adiponectin and TNF-á and response rates to treatment.

METHODS: Adiponectin (ìg/mL) and TNF-á (pg/mL) determinations by enzyme-linked

immunosorbent assay (ELISA) in serial samples (before, the middle, the end, and

6 months after the end of treatment) from 83 CHC and 59 chronic hepatitis B

(CHB) patients. Forty-three blood donors served as healthy controls. Patients

were treated with IFN-á (4.5 MU/t.i.w.) for 12 months in CHB cases, and IFN-á (3

MU/t.i.w.) plus ribavirin for 6-12 months according to hepatitis C virus (HCV)

genotype in CHC cases.

RESULTS: After adjustment for gender and body mass index (BMI), HCV genotype 3

overweight patients (BMI> 25 kg/m2) had significantly lower adiponectin (7.3 ±

2.7) at baseline compared with non-3 HCV genotype overweight patients (P <

0.05). Lower adiponectin (HCV genotype 3, P = 0.02 and HCV genotype 1, P =

0.025) and higher TNF-á (P = 0.025) at baseline were identified as independent

predictors of liver steatosis in CHC patients. Lower adiponectin was also

identified as an independent predictor of no virological response at the end of

treatment (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.66-0.87, P <

0.001). At the end of IFN-á therapy, only HCV genotype 3 patients had

significantly higher serum adiponectin (10.4 ± 6.3) compared with its levels

before treatment (8.7 ± 4.7, P < 0.05).

CONCLUSIONS: This study suggests that HCV genotype 3 may directly affect

adiponectin. This is further supported by the significant increase in

adiponectin at the end of treatment only in HCV genotype 3 patients. Serum

adiponectin at baseline appears to be an independent predictor of liver

steatosis and for the achievement of end-of-treatment virological response,

while serum TNF-á at baseline was identified as an independent predictor only of

liver steatosis.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.2007.01729.x

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