Esteatosis hepática, resistencia a la insulina y adiponectina en una población con obesidadFatty liver disease, insulin resistance and adiponectin in an obese pediatric population
Introduction
To study the clinical and laboratory relationships of fatty liver disease in a group of obese children and to investigate whether circulating adiponectin is related to fatty liver disease.
Patients and methods
Two hundred-ninety obese patients (age 4–18 years) were studied. Baseline body mass index-standard deviation score (BMI-SDS), acanthosis nigricans, blood pressure, plasma lipids, uric acid, alanine aminotransferase (ALT) and adiponectin were assessed, and a standard oral glucose tolerance test was performed. Insulin resistance (RI) was estimated by the homeostasis model assessment (HOMA) and liver steatosis was assessed by ultrasound (US). Children were classified as having metabolic syndrome if they met three or more of the following criteria: obesity, hypertension, hypertriglyceridemia, low HDL-cholesterol and impaired glucose metabolism.
Results
Fifty-two subjects (18%) had fatty liver by US and 22 (8%) had elevated ALT levels (≥40 U/L). Subjects with steatosis were significantly older (12.2±2.4 frente a 11.1±2.9 yr), heavier (BMI-SDS: 4.5±1.5 frente a 3.8±1.3), and more RI (HOMA: 3.7±1.5 frente a 2.4±1.4), but were comparable in gender, pubertal status and racial distribution to those with normal US. The prevalence of metabolic syndrome and acanthosis nigricans were also higher in the steatosis frente a the normal US group. Serum adiponectin concentration was inversely correlated with age, HOMA, ALT and uric acid and directly correlated with HDL-cholesterol. In a multiple logistic regression analysis, BMI-SDS, HOMA and serum adiponectin, but not age, uric acid or triglycerides, were the covariates independently associated with the presence of steatosis (odds ratio 1.4 [1.1-1.9]; 1.3 [1.1-1.6] and 0.9 [0.8-0.9], respectively).
Conclusions
Obesity and RI are risk factors for liver steatosis in children and adolescents. Decreased serum adiponectin is closely and independently associated with steatosis. [1]
Determinación de niveles de adiponectina en pacientes con síndrome metabólico y su correlación con el HOMA
Objectives: To measure the plasma adiponectin levels in patients with metabolic syndrome and its relationship to insulin resistance. Methods: Transversal, comparative case – control study. We conducted a survey of 70 male patients chosen at random to determine the prevalence of metabolic syndrome; they were selected from an ambulatory setting in Ciudad Bolivar, Venezuela, ages 25 to 65 years- old. We used the enzyme linked inmunoabsorbent assay method for the determination of plasma adiponectin levels and we also determined insulin resistance with the Homeostasis Model Assessment method. Results: From a sample of 70 male patients 30 (42.85 %) had 3 of the major components of the metabolic syndrome according to The National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). The plasma adiponectin levels in patients with metabolic syndrome were 10.45 @ 2.14 ng/mL and 70 @3.20 ng/mL in the control group with a significant difference between both groups and statistical significance (P< 0.01). Additionally these patients exhibited insulin resistance determined using the Homeostasis Model Assessment method: in the control group the index was 1,20 and in the patients with metabolic syndrome the Homeostasis Model Assessment index was 3.22. Conclusions: We found a high prevalence of metabolic syndrome in the studied population, decreased plasma adiponectin levels which correlated with high index of Homeostasis Model Assessment IR. The insulin resistance believed was strongly associated with atherogenic dyslipidemia and interference with carbohydrate and fat metabolism. [2]
Niveles de adiponectina en leche materna de madres con sobrepeso/obesidad y con peso normal del área metropolitana de Monterrey, México
Background
Given the current epidemic of childhood obesity, it has become increasingly important to understand the risks and protective factors associated with this disease. Breastfeeding has been identified as a protective factor; however, the mechanism responsible has not been elucidated. One of the current theories analyzes the role of hormones in breast milk, with special emphasis on adiponectin. This study aims to compare adiponectin levels in breast milk of mothers with normal weight with those in breast milk of overweight/obese mothers as well as to correlate these levels with the infant’s weight gain.
Methods
Forty samples of breast milk were analyzed for adiponectin levels using ELISA, 20 from mothers with normal weight and 20 from overweight/obese mothers.
Results
Adiponectin levels were lower in breast milk obtained from overweight/obese mothers than in breast milk from mothers with normal weight (p <0.05). When comparing infant weight gain, those fed with breast milk containing higher concentrations of adiponectin had a lower weight gain than those fed with breast milk containing low levels of the hormone (p <0.05).
Conclusions
There is a strong negative correlation between mothers’ BMI and adiponectin levels in breast milk. Mothers with a higher BMI had lower adiponectin levels in their breast milk. There is also a negative relationship between adiponectin levels in breast milk and weight gain of breastfed infants. Infants breast fed with adiponectin-rich breast milk had a lower weight gain. [3]
Serum Leptin and Adiponectin Levels in de Novo Acute Myeloid Leukemia Patients: Correlation with Clinical Characteristics
Aim of the Study: Acute myeloid leukemia (AML) is a heterogeneous clonal stem cell malignancy characterized by proliferation of immature hematopoietic cells. Adipokines in particular leptin and adiponectin are highly active molecules that attracted considerable interest due to their potential role in the development of cancer as a risk factor. We aimed to measure the body mass index, serum levels of leptin and adiponectin in AML patients, correlating these levels with standard prognostic markers of the disease.
Study Design: A total of 60 newly diagnosed AML patients and twenty healthy controls age and sex matched were enrolled.
Methodology: All cases had complete blood counts. Patients had bone marrow aspiration/biopsy specimens, EDTA peripheral blood or bone marrow aspirate specimens for flow cytometry analysis, and heparinised sample for cytogenetic study. Body mass index (BMI) was calculated by dividing body weight (kg) by square height (m2). Serum leptin and adiponectin were assayed by enzyme linked immune assays.
Results: Out of all AML patients; 33 patients (55%) presented with hepatomegaly; 29 patients (49%) presented with splenomegaly and 11 (18.3%) presented with lymphadenopathy. None of our patients showed extramedullary involvement. Serum leptin were determined at a level of 10.9±9.5 ng/ml in the patient group which is significantly lower than the controls 60.2±165.6 ng/ml (P= .05). Serum adiponectin showed highly significant lower levels in the studied group compared to controls 1.5±0.9 and 4.6±2.9 respectively (P<.001). No significant correlation was detected between serum adipokines and other clinical or laboratory parameters except a negative significant correlation was detected between serum adiponectin and bone marrow blast. Regarding cytogenetic analysis, no significant correlation was detected between cytogenetic and serum leptin and adiponectin levels (P= .98, .38), respectively.
Conclusion: The current study addressed the reduction of adipocytokines levels in AML together with negative correlation between bone marrow blasts and adiponectin levels suggesting the implication of adipocytokines in pathogenesis of AML, however these findings necessitate additional studies on large scale of cases. [4]
Correlation between Anthropometric Measures, Lipid Profile and Serum Adiponectin and Steatosis in Nondiabetic Nonalcoholic Fatty Liver Disease
Aims: To assess the relation between the grade of steatosis and anthropometric measures, lipid profile and serum adiponectin in non-diabetic patients with nonalcoholic fatty liver.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Tropical Medicine and Gastroenterology, Qena faculty of medicine, South Valley University.
Methodology: Fifty patients with US evidence suggestive of fatty liver disease and normal fasting and post-prandial serum glucose were included. No past or current history of alcohol consumption. Blood samples were taken to detect liver function tests, fasting lipogram, complete blood count and serum adiponectin. Body mass index (BMI) and waist circumferences (WC) were measured for all patients. Liver biopsy was done to detect the presence and the degree of steatosis.
Results: The mean age of patients was 40+/-12 years. Patients with steatosis showed significantly higher value for BMI and WC than those without (P value =0.000). Cholesterol, triglyceride and Low density lipoprotein-cholesterol (LDL-C) also were significantly higher in patients with steatosis (P value =0.00). High density lipoprotein-cholesterol (HDL-C) and serum adiponectin were significantly lower in patients with steatosis (P value =0.00). Patients with severe steatosis showed significantly higher values for BMI and WC, cholesterol, triglyceride, LDL-C and lower values for HDL-C and adiponectin (P value = 0.05) than those with mild or moderate steatosis. Positive correlations were detected between the age, BMI and WC, cholesterol, triglyceride, LDL-C and the grade of steatosis and negative correlations with HDL-C and adiponectin.
Conclusion: Anthropometric measures, lipogram and serum adiponectin are associated with progression of steatosis in nondiabetic patients with NAFLD. So their detection is important for evaluation and management. [5]
Reference
[1] López-Capapé, M., López-Bermejo, A., Blanco, M.A., Orejas, E.L., Blasco, J.C. and Castellanos, R.B., 2009, December. Esteatosis hepática, resistencia a la insulina y adiponectina en una población con obesidad. In Anales de Pediatría (Vol. 71, No. 6, pp. 495-501). Elsevier Doyma.
[2] Lima, M.M., López, G., Marin, A. and Rosa, F.J., 2007. Determinación de niveles de adiponectina en pacientes con síndrome metabólico y su correlación con el HOMA. Medicina Interna, 23(2).
[3] Gómez, A.G., Scheufler, P.F., Escobar, Y.Q., Magana, R.G. and De Ita, J.R., 2015. Niveles de adiponectina en leche materna de madres con sobrepeso/obesidad y con peso normal del área metropolitana de Monterrey, México. Boletín médico del Hospital Infantil de México, 72(4), pp.242-248.
[4] Ahmad Bahgat Abdulateef, N., M. Kamel, M., Salaheldin, O. and Ghareeb, M. (2016) “Serum Leptin and Adiponectin Levels in de Novo Acute Myeloid Leukemia Patients: Correlation with Clinical Characteristics”, International Blood Research & Reviews, 5(1), pp. 1-8. doi: 10.9734/IBRR/2016/23857.
[5] Mahmoud, H. S., Helal, M. M., Hassan, M. H. and Sherif, M. F. (2015) “Correlation between Anthropometric Measures, Lipid Profile and Serum Adiponectin and Steatosis in Nondiabetic Nonalcoholic Fatty Liver Disease”, Journal of Advances in Medicine and Medical Research, 7(9), pp. 771-778. doi: 10.9734/BJMMR/2015/16594.
