Study Of The Relationships Between The Levels Of Serum Visfatin And Adiponectin And Insulin Resistance In Patients With Nonalcoholic Fatty Liver Disease

Objective:To measure levels of serum visfatin and adiponectin in patients with nonalcoholic fatty liver disease(NAFLD).To investigate the relationship between serum visfatin ,adiponectin and insulin resistance,and the role of visfatin and adiponectin in the pathogenesis and progression of NAFLD.Methods:55 patients(including 23 mild,18 moderate ,14 severe)with NAFLD and the 28 control subjects were enrolled in this study.The height,weight,waist circumstance and hip girth of all subjects were obtained by standard methods.To all the subjects,the parameters including fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-c),low-density lipoprotein cholesterol (LDL-c), alanine aminotransferase(ALT) , aspartate aminotransferase(AST),gamma glutamyl transferase(GGT) and fasting serum insulin(FINS)were measured.Serum visfatin and adiponectin were measured by enzyme-linked immunosorbent assay(ELISA).Body mass indexes (BMI),waist hip ratio(WHR),body fat percentage(BF%) were calculated with formula.Homeostasis model assessment was applied to assess the status of insulin resistance index(HOMA-IR).The relationships between serum visfatin ,adiponectin and various parameters in patients with NAFLD were observed and analyzed by statistical methods.Results:1.In the NAFLD group,BMI,WHR and BF% were higher than those of control group,the differences were significant.(P<0.05).2.There were no significant differences on the level of HDL-c and LDL-c between the NAFLD group and the control group(P >0.05).In the NAFLD group,FBG,FINS,HOMA-IR,TG,TC,ALT,AST,GGT,visfatin were higher than those of control group,while adiponectin was lower , the differences were all significant between two groups (P<0.05). 3.The difference in HOMA-IR level was not significantly different between the mild and moderate NAFLD groups(P >0.05),Which were both lower than the severe group (P<0.05), which is the same to serum visfatin. And serum adiponectin was significantly lower from the mild to the severe group(P<0.05).4.There was positively significant correlation between serum visfatin and BMI,WHR,BF%,FINS,HOMA-IR,FBG,ALT,GGT in NAFLD group,while There was significant correlation between serum adiponectin and sex,BMI,BF%,FBG,FINS,HOMA-IR,TG,ALT,GGT(P<0.05 respectively).But there was no correlation between serum visfatin and adiponectin.5. After multiple stepwise regression analysis,the results showed that HOMA-IR and BF%were the most important factor for affecting the levels of serum visfatin (P<0.05), while HOMA-IR and TG were the most important factor for affecting the levels of serum adiponectin(P<0.05).Conclusions:1.The levels of serum adiponectin in patients with NAFLD were significantly lower than those of controls,and decreased with the severity of NAFLD. Low-fat adiponectin hyperlipidemia participates in the pathogenetic progresss of NAFLD.2.The levels of serum visfatin in patients with NAFLD were significantly higher than those of controls,.Serum visfatin in patients with NAFLD was correlated with insulin resistance,and it may participate in the pathogenetic progresss of NAFLD.3.The levels of serum visfatin in patients increased with the severity of NAFLD may be involved in the development of steatohepatitis and liver fibrosis.