The Changes And Significance Of Serum Chemerin Level In Patients With Nonalcoholic Fatty Liver Disease

Objective: To investigate changes and significance of serum chemerin level in patients with non-alcoholic fatty liver disease(NAFLD).Methods: Seventy two cases(NAFLD group), 47 male and 25 female,with non-alcoholic fatty liver disease were admitted to the Department of Gastroenterology in the Hospital of Hebei Gucheng from January 2014 to December 2012. Their average age is 59.41±9.08 years. 102 cases of healthy people(63 males, 39 females),with mean age of 61.07 ± 6.73 years, were randomly selected as the control group. The experimental group should meet the following conditions:(1) no history of drinking or alcohol consumption<140g / week(F <70g / week).(2) imaging or histology showed steatosis.Inclusion criteria : no history of viral hepatitis; no abnormal liver function.Exclusion criteria for all subjects: history of heavy drinking; viral hepatitis,drug-induced hepatitis, autoimmune hepatitis, Wilson’s disease, infection and other specific diseases that causes fatty liver disease; ahyperthyroidism or hypothyroidism, cancer, blood system disorders, obstructive sleep apnea, etc;polycystic ovary syndrome(PCOS) in pregnancy, lactation and oral contraceptives women. According to the level of serum chemerin, all the subjects were divided into three subgroups, namely low concentrations(<65.14 ng / ml) 54 cases, the middle dose group(65.14-79.29 ng / ml) 69 cases,high concentrations(> 79.29 ng / ml) 51 cases.NAFLD imaging diagnosis:(1) diffuse liver area near field echo strongly enhanced in the spleen and kidney far field echo decays(2) pipeline structure in the liver showed unclear(3) liver mild to moderate swelling, edge angle round blunt(4) with color Doppler flow imaging tips hepatic color flow signal to reduce or to display, but intrahepatic distribution of the blood vessels in the normal(5) echo across the right lobe of the liver capsule and transversedisplay unclear or incomplete. The NAFLD group was further divided into three subgroups, mild NAFLD group, moderate NAFLD group and severe NAFLD group. A mild NAFLD group(21cases) with the above first and 2-4items, two of the above first and 2-4 items for the moderate NAFLD group(27cases), and two of the above first as well as and fifth for the 2~4items for the sever NAFLD group(24cases).All the subjects of sex、age、occupation、past history(heart、brain、liver、kidney and other diseases)、 family history、 smoking history、medication history, diet and so on were investigated and recorded. Their height and weight were measured specially,then worked out body mass index BMI = weight(Kg)/ height(m2).Blood pressure, heart rate, row physical examination and abdominal CT were also measured if need.The subjects were fasting for more than 12 hours, and their venous blood were collected on the second morning. Fasting blood glucose(FBG), fasting insulin(FINS), glycosylated hemoglobin(Hb Alc), triglyceride(TG), total cholesterol(CHOL), low-density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), high-sensitivity C-reactive protein(hs-CRP) and other biochemical indicators were measured by Roche Cobas-8000 automatic biochemical analyzer used in our hospital. Calculated according to the formula: HOMA-IR(insulin resistance index)=fasting glucose levels(FBG, mmol/L)×fasting insulin levels(FINS, m IU/L)/22.5.Another venous blood 5ml was collected. Chemerin serum levels were measured by enzyme-linked immunosorbent assay.SPSS19.0 version of statistical software was used for data processing and statistical analysis.Measurement data in line with the normal distribution were presented as mean±standard deviation and count data were expressed as a percentage.T test was used to compare two means and One-Way ANOVA was used to compare multiple means.χ2 test was used to compare count data and Pearson correlation was used in bivariate analysis. Logistic regression analysis was used in the degree of correlation analysis. P <0.05 was considered statistically significant.Results:1 The comparison of general clinical data There was no significant difference(P>0.05) in age、years、sex ratio、the prevalence of hypertension、smoking history between experimental group and control group. Compared to control group, BMI was higher(27.80±3.12kg/m2 vs. 23.21±3.24kg/m2) in experimental group, and the difference was statistically significant(P<0.05).2 The comparison of serum chemerin level Serum chemerin level in experimental group was higher than in control group( 81.02±13.11ng/ml vs.62.21±12.32ng/ml, P <0.01).3 Compared to control group、CHOL、TG、LDL-C、Hb Alc、FBG、HOMA-IR, and hs-CPR were higher(5.12±0.63mmol/L vs. 4.31±1.05mmol/L;2.25±1.42mmol/L vs. 1.52±1.21mmol/L; 3.62 ± 0.55mmol/L vs.2.45±0.87mmol/L; 5.91±0.31% vs. 5.21±0.47%; 5.80±0.1.62mmol/L vs.5.05±1.89mmol/L; 3.51 vs. 2.68; 3.17±1.31mmol/L vs. 1.24±0.84mmol/L) in experimental group, and the difference was statistically significant(P<0.05).Compared to control group, HDL-C was lower(1.41±0.26mmol/L vs. 1.73±0.37mmol/L) in experimental group, and the difference was statistically significant(P<0.05).4 Comparison of chemerin levels among subgroups From the lower concentration group to the higher concentration group,BMI, TG, HOMA-IR and hs-CRP were increased in turn,HDL-C were decreased,and the difference was statistically significant(P<0.05).5 Comparison between NAFLD group subgroup The levels of serum Chemerin, hs-CRP and HOMA-IR in the severe NAFLD group were significantly higher than those in the moderate NAFLD group and mild NAFLD group(<0.05 P).6 Correlation analysis of serum chemerin levels and the indicators In all subjects, serum chemerin levels was positively correlated with BMI, TG,CHOL, LDL, FBG, HOMA-IR and hs-CRP(r=0.406, 0.496, 0.284, 0.426,0.322, 0.528, 0.301 respectively; P<0.05), and was negatively correlated with HDL-C(r=-0.376, P<0.05).7 With the occurrence of non-alcoholic fatty liver considered to be the dependent variable, and gender, age, suffers from high blood pressure,HOMA-IR, HAblc, TG, CHOL, LDL-C, HDL-C, hs-CPR and chemerin considered to be independent variables, Logistic regression analysis was carried and it showed that chemerin was a relevant factor of non-alcoholic fatty liver.(OR= 2.071, P <0.01) Logistic regression analysis was carried,after adjusted for age, sex, BMI, blood glucose, blood lipid, HOMA-IR,treating Chemerin as independent variable, lowest Chemerin of lower concentration group as the reference, the results showed that the intermediate concentration and high concentration of OR were 2.835, 4.933(P <0.01).Conclusion:1 Serum chemerin was highly expressed in non alcoholic fatty liver disease patients, and with the severity of the disease, the serum chemerin showed a gradually increasing trend;2 Serum chemerin levels were positively correlated with hs-CRP, IR and other biochemical parameters;3 Higher concentrations of chemerin may be a risk factor for the occurrence of nonalcoholic fatty liver disease.