PMID- 19360015
OWN - NLM
STAT- MEDLINE
DCOM- 20091105
LR  - 20240404
IS  - 1930-7381 (Print)
IS  - 1930-7381 (Linking)
VI  - 17
IP  - 9
DP  - 2009 Sep
TI  - Triglyceride levels and not adipokine concentrations are closely related to 
      severity of nonalcoholic fatty liver disease in an obesity surgery cohort.
PG  - 1696-701
LID - 10.1038/oby.2009.89 [doi]
AB  - Although nonalcoholic fatty liver disease (NAFLD) is frequent in obesity, the 
      metabolic determinants of advanced liver disease remain unclear. Adipokines 
      reflect inflammation and insulin resistance associated with obesity and may 
      identify advanced NAFLD. At the time of obesity surgery, 142 consecutive patients 
      underwent liver biopsy and had their preoperative demographic and clinical data 
      obtained. Liver histology was scored by the NAFLD activity score, and patients 
      subdivided into four groups. Concentrations of retinol-binding protein 4 (RBP4), 
      adiponectin, tumor necrosis factor-alpha (TNF-alpha), and leptin were determined 
      approximately 1 week prior to surgery and results were related to liver 
      histology. The prevalence of no NAFLD was 30%, simple steatosis 23%, borderline 
      nonalcoholic steatohepatitis (NASH) 28%, and definitive NASH 18%. Type 2 diabetes 
      mellitus (T2DM) and metabolic syndrome (MS) prevalence were 39 and 75%, 
      respectively, and did not differ across the four histological groups (P = NS). 
      Triglyceride (TG) and alanine transaminase (ALT) levels, strongly associated with 
      advanced stages of NAFLD and NASH (P = 0.04). TG levels >150 mg/dl, increased the 
      likelihood of NASH 3.4-fold, whereas high-density lipoprotein (HDL) levels 
      predicted no NAFLD (P < 0.01). Concentrations of TNF-alpha, leptin, and RBP4 did 
      not differ among histological groups and thus did not identify NASH; however, 
      there was a trend for adiponectin to be lower in NASH vs. no NAFLD (P = 0.061). 
      In summary, both TG and ALT levels assist in identification of NASH in an obesity 
      surgery cohort. These findings underscore the importance of fatty acid delivery 
      mechanisms to NASH development in severely obese individuals.
FAU - Kashyap, Sangeeta R
AU  - Kashyap SR
AD  - Endocrinology Institute, Cleveland Clinic, Cleveland, Ohio, USA. kashyas@ccf.org
FAU - Diab, Dima L
AU  - Diab DL
FAU - Baker, Allison R
AU  - Baker AR
FAU - Yerian, Lisa
AU  - Yerian L
FAU - Bajaj, Harpreet
AU  - Bajaj H
FAU - Gray-McGuire, Courtney
AU  - Gray-McGuire C
FAU - Schauer, Philip R
AU  - Schauer PR
FAU - Gupta, Manjula
AU  - Gupta M
FAU - Feldstein, Ariel E
AU  - Feldstein AE
FAU - Hazen, Stanley L
AU  - Hazen SL
FAU - Stein, Catherine M
AU  - Stein CM
LA  - eng
GR  - M01 RR018390-056219/RR/NCRR NIH HHS/United States
GR  - K12 RR023264/RR/NCRR NIH HHS/United States
GR  - M01 RR018390/RR/NCRR NIH HHS/United States
GR  - 5K12RR023264/RR/NCRR NIH HHS/United States
GR  - K12 RR023264-04/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20090409
PL  - United States
TA  - Obesity (Silver Spring)
JT  - Obesity (Silver Spring, Md.)
JID - 101264860
RN  - 0 (ADIPOQ protein, human)
RN  - 0 (Adipokines)
RN  - 0 (Adiponectin)
RN  - 0 (Biomarkers)
RN  - 0 (Leptin)
RN  - 0 (RBP4 protein, human)
RN  - 0 (Retinol-Binding Proteins, Plasma)
RN  - 0 (Triglycerides)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - EC 2.6.1.2 (Alanine Transaminase)
SB  - IM
MH  - Adipokines/*blood
MH  - Adiponectin/blood
MH  - Adult
MH  - Alanine Transaminase/blood
MH  - *Bariatric Surgery/methods
MH  - Biomarkers/blood
MH  - Biopsy
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Fatty Liver/blood/*etiology/pathology
MH  - Female
MH  - Humans
MH  - Laparoscopy
MH  - Leptin/blood
MH  - Liver/enzymology/pathology
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Obesity/blood/*complications/surgery
MH  - Predictive Value of Tests
MH  - Retinol-Binding Proteins, Plasma/metabolism
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Triglycerides/*blood
MH  - Tumor Necrosis Factor-alpha/blood
PMC - PMC2829436
MID - NIHMS173304
COIS- DISCLOSURE The authors declared no conflict of interest.
EDAT- 2009/04/11 09:00
MHDA- 2009/11/06 06:00
PMCR- 2010/02/27
CRDT- 2009/04/11 09:00
PHST- 2009/04/11 09:00 [entrez]
PHST- 2009/04/11 09:00 [pubmed]
PHST- 2009/11/06 06:00 [medline]
PHST- 2010/02/27 00:00 [pmc-release]
AID - oby200989 [pii]
AID - 10.1038/oby.2009.89 [doi]
PST - ppublish
SO  - Obesity (Silver Spring). 2009 Sep;17(9):1696-701. doi: 10.1038/oby.2009.89. Epub 
      2009 Apr 9.