Poster Presentations

Session Title: ALCOHOLIC LIVER DISEASE, NAFLD AND DRUG-INDUCED LIVER DISEASE - b) CLINICAL
Presentation Date: Apr 25, 2009

CAN SERUM LEPTIN AND ADIPONECTIN PREDICT LIVER INJURY IN PATIENTS WITH NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD)? A STUDY IN THE GENERAL POPULATION

S. Zelber-Sagi¹, V. Ratziu², L. Blendis¹, G. Morali³, Z. Halpern¹, R. Oren^1
1Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, ²Université Pierre et Marie Curie, Hôpital Pitié Salpêtrière, Paris, France, ³Shaare Zedek Medical Center, Jerusalem, Israel

Background: Leptin and adiponectin are implicated in the development of NAFLD. However, the place of adipocytokines as a screening tool for NAFLD and NASH can not be evaluated in the general population due to the invasive nature of liver biopsy. The noninvasive biomarker FibroMax enables to overcome these limitations.
Aim: To evaluate the association between adipocytokines and NAFLD at the population level.
Methods: A cross-sectional study (n=375) sampled from the Israeli National Health Survey. Exclusion criteria were any known etiology for liver disease other than primary NAFLD. Leptin, adiponectin and FibroMax (Biopredictive, France) were measured.
Results: 349 volunteers met the inclusion criteria. Steatosis (≥S2) was observed in 21% subjects. Fibrosis in 26% and borderline-advanced fibrosis (≥F2) in 12.7%. Borderline NASH in 31.7% and NASH in 0.9%. Adiponectin (OR=0.92, 0.85-0.99 95%CI) and leptin (1.04, 1.02-1.06) were among the strongest independent predictors for steatosis along with abdominal obesity, triglycerides, glucose and HDL.The independent predictors for borderline NASH were adiponectin (0.93, 0.87-0.99) and leptin (1.03, 1.01-1.05) along with HDL, abdominal obesity, serum triglycerides and HbA1C. The age and gender adjusted OR for borderline NASH was 4.6 (1.7-12.5) for low adiponectin or high leptin and 26 (8.2-81) when both were present (Fig. 1). The FibroTest test was not associated with leptin and adiponectin.
Conclusions: Low adiponectin and high leptin are among the strongest predictors for steatosis and NASH. Moreover, combining both low adiponectin and high leptin has a strong predictive value for the presence of NASH. However, fibrosis cannot be predicted by these adipocytokines.
Fig 1. Odds ratio for borderline NASH or NASH according to leptin and adiponectin above and below the upper quartile, adjusted for age and gender


[Fig 1. Odds ratio for borderline NASH or NASH]