Serum adiponectin level as a prognostic marker Of NASH in obese type II Diabetic Egyptian patients

Abstract

NAFLD is closely associated with obesity, insulin resistance, and dyslipidemia. Two broad types are recognized (simple steatosis is typically stable while NASH is characterized by significant cell injury and the potential for progression to cirrhosis). Although non-invasive markers of histological injury are under study, the accurate diagnosis of NASH remains dependent on specific histological parameters in theliver biopsy. The key parameters include steatosis (usually mixed macro- and microvesicular), cellular ballooning, inflammation and fibrosis which ranges from slight perisinusoidal fibrosis to bridging and cirrhosis. Measuring serum adiponectinis recently discovered protein hormones produced and secreted by adipocytes may serve as predictors of progressive liver pathology in NAFLD. The aim of our study was to evaluate the use of serumadiponectin as a non invasivediagnostic test of fatty liver disease. Adiponectin is an insulin sensitizing adipokine possessing multiple beneficial effects on obesity-related medical complications and low level of this adipokine represents an independent risk factor for NAFLD. This study was conducted on twenty diabetic obese patients (BMI above 30) with suspected fatty liver by abdominal ultrasound( group C), twenty diabetic patients without fatty liver ( group B)and twenty apparently healthy non-obese not diabetic subjectswithout fatty liver were included as a control group for serum adiponectin( group A) were subjected to the following: Full history taking and physical examination, full anthropometric measurements, laboratory studies including serum adiponectin and abdominal US. The present study showed that patients with NAFLD with type II DM( group C) have lower level of serum adiponectin than patients with type II DM( group B) and control group( group A). ALT, AST were significantly higher in ( group C) than ( group A&B). From these results, it was concluded that adiponectin can be combined with other noninvasive markers to predict the presence of NASH to replace liver biopsy but this needs further studies on a larger number of patients.