Adipokines levels are associated with the severity of liver disease in patients with alcoholic cirrhosis

Table 1 Baseline clinical and laboratory characteristics of study population

	All patients (n = 40)	CP A (n = 18)	CP B (n = 10)	CP C (n = 12)	P value1
Sex (M/F), n (%)	35/5 (87.5/12.5)	16/2 (88.9/11.1)	9/1 (90/10)	10/2 (83.3/16.7)	0.870
Age, median years (range)	59 (37-75)	59.5 (43-75)	60.5 (37-71)	59 (45-70)	0.838
Smoking, n (%)	15 (37.5)	7 (38.9)	3 (30)	5 (41.7)	0.954
HCC, n (%)	5 (12.5)	1 (5.6)	1 (10)	3 (25)	0.277
Hemoglobin (11.8-17 g/dL)	12.35 (9.3-16.6)	14.3 (9.8-16.6)	12.75 (10.2-15.1)	10.1 (9.3-13.2)	0.002
WBC count (4 × 109/L-11 × 109/L)	5.888 (3.2-15.18)	6.66 (3.2-12.97)	5.31 (4.1-8.97)	5.66 (4.15-15.18)	0.093
Platelet count (150 × 109/L-400 × 109/L)	113 (81-246)	148 (87-246)	117.5 (70-198)	127 (75-218)	0.306
INR (1-1.3)	1.28 (0.87-2.32)	1.09 (0.87-1.59)	1.2 (1.07-1.92)	1.58 (1.24-2.32)	0.001
PT (s)	15.25 (9.8-24.8)	11.9 (9.8-18.3)	15.15 (12.2-17)	18.6 (15.2-24.8)	< 0.001
Total bilirubin (0.1-1.3 mg/dL)	1.1 (0.28-8.6)	0.72 (0.28-1.19)	1.23 (0.85-3.5)	2.4 (1.6-8.6)	< 0.001
Albumin (3.5-5.5 g/dL)	3.65 (0.9-4.6)	4 (3.4-4.6)	3.6 (2.6-4.3)	2.8 (0.9-3.2)	< 0.001
Creatinine (0.9-1.6 mg/dL)	0.82 (0.68-1.8)	0.88 (0.7-1.7)	0.82 (0.7-1.4)	0.8 (0.68-1.8)	0.967
Urea (15-54 mg/dL)	28 (16-110)	28 (18-64)	26.5 (21-47)	29 (16-110)	0.981
SGOT (5-40 U/L)	36 (15-149)	32.3 (15-48)	59 (24-149)	58 (18-128)	0.017
SGPT (5-40 U/L)	33 (8-156)	32 (8-60)	46 (23-156)	32 (11-64)	0.298
ALP (U/L)	116 (37-303)	104 (41-236)	113.5 (75-244)	123 (37-303)	0.324
GGT (U/L)	94 (12-328)	82.5 (12-231)	135 (61-328)	108 (28-199)	0.057
Glucose (75-115 mg/dL)	99 (60-126)	99 (71-126)	105 (94-126)	92 (60-118)	0.170
Serum sodium (134-152 mmol/L)	138 (129-146)	140.8 (134.5-146)	137.4 (135-141)	135 (129-142)	0.012
Cholesterol (mg/dL)	146 (66-341)	188.5 (130-341)	133 (91-173)	146 (66-168)	0.041
Triglycerides (mg/dL)	88.5 (43-142)	106 (43-142)	74.5 (47-139)	76 (46-116)	0.525
Child-Pugh score (range)	7 (5-12)	NA	NA	NA	NA
MELD score (range)	10 (6-25)	7 (6-16)	11 (8-18)	18 (13-25)	< 0.001
Ascites, n (%)	14 (35)	0	4 (40)	10 (83.3)	< 0.001
Encephalopathy, n (%)	2 (5)	1 (5.6)	0	1 (8.3)	0.664

¹P value: correlation of variables regarding different stages of liver disease. CP: Child-Pugh; HCC: Hepatocellular carcinoma; WBC: White blood cells; INR: International normalized ratio; PT: Prothrombin time; SGOT: Aspartate aminotransferase; SGPT: Alanine aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl-transferase; MELD: Model for End-stage Liver Disease; BMI: Body mass index; NA: Not applicable.

Table 2 Baseline somatometric characteristics of study population

	All patients (n = 40)	CP A (n = 18)	CP B (n = 10)	CP C (n = 12)	P value1
BMI (kg/m2) (range)	25.89 (20.08-39.31)	26.29 (21.34-30.52)	27.39 (20.76-39.3)	25.29 (20.08-35.64)	0.449
BMI (kg/m2) (%)
18.5-24.9	33.3	21.4	40	44.4	0.261
25-29.9	51.5	71.4	30	44.4
> 30	15.2	7.1	30	11.1
Fat, % (range)	23. 4 (7.6-42.1)	24.3 (18.7-32.9)	23 (16.3-38.5)	19.9 (7.6-42.1)	0.522
Fat mass, kg (range)	17.81 (5.49-45.4)	17.97 (10.73-29.02)	14.62 (11.41-45.4)	13.87 (5.5-35.74)	0.454
FFM, kg (range)	56.145 (39.56-74.4)	54.475 (46.67-67.31)	58.59 (48.89-74.4)	55.83 (39.56-66.7)	0.234
TBW, kg, (range)	40.63 (29.83-58.82)	40.875 (34.36-45.36)	41.025 (30.52-58.82)	39.01 (29.83-43.45)	0.300

¹P value: correlation of variables regarding different stages of liver disease. CP: Child-Pugh stage; BMI: Body mass index; FFM: Fat-free mass; TBW: Total body water.

Table 3 Association of adipokines with demographic, biochemical and anthropometric characteristics

	Leptin	Adiponectin	Resistin	Visfatin	RBP4	Apelin
	r (P value)	r (P value)	r (P value)	r (P value)	r (P value)	r (P value)
Age (yr)	-0.012 (0.94)	0.206 (0.203)	0.127 (0.434)	-0.014 (0.933)	0.178 (0.273)	-0.059 (0.716)
Hemoglobin (g/dL)	-0.299 (0.081)	-0.055 (0.75)	-0.138 (0.422)	0.314 (0.066)	0.582 (< 0.001)	0.197 (0.249)
WBC count	-0.268 (0.115)	-0.077 (0.653)	0.262 (0.117)	-0.027 (0.875)	0.195 (0.247)	-0.021 (0.902)
Platelet count	-0.298 (0.082)	-0.097 (0.575)	0.165 (0.337)	-0.007 (0.966)	0.238 (0.163)	-0.006 (0.973)
INR	0.349 (0.059)	0.395 (0.028)	-0.056 (0.767)	0.185 (0.327)	-0.493 (0.008)	0.136 (0.466)
PT (s)	0.387 (0.038)	0.373 (0.043)	0.055 (0.772)	0.172 (0.373)	-0.473 (0.005)	0.024 (0.899)
Total bilirubin (mg/dL)	-0.081 (0.648)	0.403 (0.016)	0.204 (0.24)	-0.07 (0.694)	-0.37 (0.029)	-0.122 (0.484)
Albumin (g/dL)	-0.424 (0.014)	-0.179 (0.311)	-0.115 (0.516)	-0.215 (0.229)	0.32 (0.065)	0.132 (0.457)
Creatinine (mg/dL)	0.271 (0.105)	0.055 (0.741)	0.241 (0.145)	0.027 (0.872)	0.251 (0.128)	-0.177 (0.288)
Urea (mg/dL)	0.263 (0.116)	0.268 (0.103)	0.147 (0.378)	0.011 (0.948)	0.149 (0.371)	-0.158 (0.342)
SGOT (U/L)	0.031 (0.859)	0.589 (< 0.001)	0.145 (0.392)	0.177 (0.302)	-0.169 (0.319)	0.186 (0.269)
SGPT (U/L)	0.186 (0.279)	0.443 (0.006)	-0.064 (0.707)	0.18 (0.292)	0.039 (0.817)	0.248 (0.139)
ALP (U/L)	0.072 (0.716)	0.381 (0.04)	0.069 (0.722)	0.252 (0.196)	-0.259 (0.175)	-0.013 (0.946)
GGT (U/L)	0.174 (0.358)	-0.222 (0.231)	0.083 (0.658)	0.151 (0.424)	0.292 (0.111)	-0.028 (0.882)
Glucose (mg/dL)	0.064 (0.723)	-0.184 (0.298)	-0.212 (0.228)	0.131 (0.466)	0.115 (0.516)	-0.108 (0.543)
Serum sodium (mmol/L)	-0.183 (0.299)	-0.001 (0.997)	-0.154 (0.376)	0.078 (0.662)	0.174 (0.316)	0.211 (0.224)
Cholesterol (mg/dL)	-0.159 (0.529)	0.208 (0.392)	-0.163 (0.505)	-0.22 (0.38)	0.036 (0.882)	-0.131 (0.594)
Triglycerides (mg/dL)	-0.421 (0.092)	-0.365 (0.137)	0.117 (0.645)	-0.318 (0.213)	0.401 (0.099)	0.096 (0.706)
Height (cm)	-0.76 (0.679)	-0.357 (0.041)	-0.083 (0.647)	-0.269 (0.136)	0.206 (0.25)	0.02 (0.912)
Weight (kg)	0.607 (P < 0.001)	-0.03 (0.867)	-0.019 (0.917)	0.152 (0.405)	0.306 (0.083)	0.136 (0.45)
BMI (kg/m2)	0.705 (< 0.001)	0.163 (0.365)	0.01 (0.956)	0.304 (0.09)	0.202 (0.26)	0.149 (0.408)
Fat, %	0.783 (< 0.001)	0.186 (0.325)	-0.074 (0.696)	0.391 (0.036)	0.261 (0.164)	0.211 (0.263)
Fat mass, kg	0.794 (P < 0.001)	0.112 (0.556)	-0.071 (0.708)	0.41 (0.027)	0.333 (0.072)	0.22 (0.243)
FFM, kg	0.136 (0.472)	-0.1 (0.6)	-0.063 (0.743)	0.001 (0.998)	0.153 (0.42)	0.102 (0.592)
TBW, kg	0.312 (0.082)	-0.198 (0.27)	0.083 (0.648)	-0.004 (0.981)	0.389 (0.025)	0.1 (0.58)

RBP4: Retinol-binding protein 4; WBC: White blood cells; INR: International normalized ratio; PT: Prothrombin time; SGOT: Aspartate aminotransferase; SGPT: Alanine aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl-transferase; FFM: Fat-free mass; BMI: Body mass index; TBW: Total body water.

Table 4 Serum levels of adipokines in study population

	All patients (n = 40)	CP A (n = 18)	CP B (n = 10)	CP C (n = 12)	P value1
Leptin, ng/mL (range)	6.22 (1.04-53.87)	6.64 (1.43-30.75)	8.68 (3.07-53.87)	3.11 (1.04-42.53)	0.396
Adiponectin, μg/mL (range)	10.23 (2.13-77.75)	7.99 (2.13-47.67)	7.66 (4.9-76.85)	25.73 (3.48-77.75)	0.040
Resistin, ng/mL (range)	0.78 (0.43-1.07)	0.82 (0.43-1.03)	0.74 (0.47-1.004)	0.88 (0.52-1.07)	0.460
Visfatin, ng/mL (range)	4.5 (0.1-109)	3.74 (0.1-100)	12.32 (0.1-100)	4.5 (0.1-109)	0.536
Apelin, ng/mL (range)	5.595 (1.53-9.74)	5.83 (2.23-9.27)	6.94 (2.43-9.74)	3.97 (1.53-6.74)	0.034
RBP4, μg/mL (range)	5.12 (1.88-13.04)	6.48 (2.6-13.04)	6.56 (3.9-12.12)	2.89 (1.94-9.42)	0.006

¹P value: Correlation of variables regarding different stages of liver disease. CP: Child-Pugh stage; RBP4: Retinol-binding protein 4.

Table 5 Serum levels of adipokines in patients with and without ascites

	Patients with ascites (n = 14)	Patients without ascites (n = 26)	P value
Leptin (range)	3.54 (1.04-42.53)	7.41 (1.43-53.87)	0.356
Adiponectin (range)	21.08 (4.06-77.75)	7.14 (2.125-72.8)	0.008
Resistin (range)	0.79 (0.47-1.06)	0.78 (0.43-1.07)	0.799
Visfatin (range)	10.4 (0.1-109)	4.01 (0.1-100)	0.219
Apelin (range)	4.01 (1.53-7.5)	6.09 (2.23-9.74)	0.089
RBP4 (range)	3.04 (1.88-8.6)	6.69 (2.6-13.04)	0.001

RBP4: Retinol-binding protein 4.