Changes Of Serum Adiponectin Levels And Their Clinical Significances In Patients With Chronic Liver Disease

Objiective: The goal of this thesis is to detect the expression of serum adiponectin in patients with chronic hepatitis B,chronic hepatitis C or cirrhosis,in order to investigate the relationship between serum adiponectin and the progress of chronic viral hepatitis and to evaluate the value of its reflecting of cirrhosis.Methods: This study is based on the overseeing of 136 patients with chronic viral hepatitis and 32 controls. The patient group with the average age of 39.5±7.2 years including 94 men and 42 women,consists of 33 individuals with chronic hepatitis B,31 individuals with chronic hepatitis C and 72 individuals with cirrhosis. The 72 liver cirrhosis patients were classified into 3 categories in accordance with the Child-Pugh Classification:22 A grades,24 B grades and 26 C grades. The serum adiponectin of the patients and controls were detected by a method of Enzyme-linked immunoassay (ELISA). The content of TGF-β1,C-Ⅳ,LN,HA,ALT,ALB,PT,TBIL were also detected in the serum of patients with liver cirrhosis. ALT,TBILand ALB were detected by a full automatic biochemical analyzer,PT was detect by using a automatic coagulation analyzer,and the rest were detected by ELISA.Results: The serum adiponectin levels of patients with cirrhosis were significantly higher than those of the chronic hepatitis B group,the chronic hepatitis C group and the control group(.P<0.05)But there were no significant difference between the three groups that had a relative lower serum adiponectin level.(P>0.05)In the cirrhosis group,there was a obvious increase of serum adiponectin only between grade A and grade C.(P<0.05)The up-regulation of these indicators that indicating hepatic fibrosis such as TGF-β1,C-Ⅳ,LN,HA,were correlated with the grade of Child-Pugh Classification.(the correlation coefficients were 0.477,0.544,0.661,0.624,and each P is lower than 0.01)There was a negative correlation between ALB and adiponectin,(r=﹣0.430,P<0.01)but a ppositive correlation between adiponectin and PT (r=0.600,P<0.01)or TBIL(r=0.584,P<0.01),and there was no significant correlation between adiponectin and ALT in serum of patients with liver cirrhosis.(r=0.058,P>0.05)Conclusions: The serum adiponectin in patients with cirrhosis is significantly increased,it may play a role in the fibrosis progression of chronic liver diseases and is helpful for the diagnosis of cirrhosis. There is a negative correlation between serum adiponectin and ALB and a positive correlation between serum adiponectin,PT and TBIL but there is no significant correlation between serum adiponectin and ALT,so the serum adiponectin level may be one of the indices of the functional reserve of liver. The relationship between the serum adiponectin and the Child-Pugh Classification in patients with cirrhosis is still not very clear,a further research of expanded sample between them may be needed in the future.