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Serum biomarkers in type 2 diabetic patients with non-alcoholic steatohepatitis and advanced fibrosis

, : Serum biomarkers in type 2 diabetic patients with non-alcoholic steatohepatitis and advanced fibrosis. Hepatology Research 43(5): 508-515

Advanced stages of non-alcoholic fatty liver disease (NAFLD) are highly prevalent in type 2 diabetes (T2DM), however no diabetes-related or biochemical variable seems to be predictive of severity of NAFLD. The aim was to investigate the association of several serum biomarkers with the more severe histopathological stages of NAFLD in T2DM. In a cross-sectional design, 84 T2DM patients with biopsy-proven NAFLD had adiponectin, TNF-?, TGF-?1, interleukins 6, 8 and 10 and C-reactive protein measured. NAFLD severity was evaluated by two hepatopathologists according to the non-alcoholic steatohepatitis (NASH) Clinical Research Network scoring system. Independent associations of cytokines with NASH and advanced fibrosis were evaluated by multivariate logistic regressions. Sixty-six patients (78.6%) had NASH, and 52 patients (61.9%) had advanced fibrosis considering the highest score between the 2 pathologists. Patients with NASH or with advanced fibrosis had equal cytokine levels than those without NASH or with absent/light fibrosis, except for a lower serum adiponectin (8.59 vs 12.77 ?g/ml; p=0.015) in patients with NASH, and a lower TGF-?1 (170 vs 180 pg/ml; p=0.026) in patients with advanced fibrosis. In multivariate analysis, lower adiponectin was independently associated with NASH (odds ratio: 7.7, 95%CI: 1.5-39.9, p=0.014, for the subgroup with adiponectin below the median value), whereas both lower adiponectin and lower TGF-?1 levels were associated with advanced fibrosis. Low adiponectin and low TGF-?1 are associated with severest NAFLD stages in T2DM and might be a valuable tool to support liver biopsy indication in this setting.


PMID: 23067270

DOI: 10.1111/j.1872-034X.2012.01106.x

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