ADIPOCYTOKINES LEPTIN AND RESISTIN IN PATIENTS WITH DIABETES MELLITUS AND HYPERTENSION DEPENDING ON THE PRESENCE OF CONCOMITANT METABOLIC-ASSOCIATED STEATOSIS OF THE LIVER

Abstract

The literature data on the content of adipokines leptin and resistin in patients with nonalcoholic fatty liver disease (NAFLD) and liver steatosis (LS) are controversial, that is why it determined the relevance and feasibility of our study.

The aim of the study was to investigate the levels of adipokines leptin and resistin in patients with concomitant NAFLD (LS). We examined 35 patients with arterial hypertension (AH) and type 2 diabetes mellitus, and divided them into groups with LS (n=24, average age 55.83±0.89 years) and without it (n=11, age 53.00±1.55 years). The groups were identical in terms of gender, age, duration of AH, and glycemic control. In addition to standard laboratory tests, we measured indicators of carbohydrate metabolism, two adipokines leptin and resistin, tumor necrosis factor-alpha (TNF-α), selectin and interleukins (IL)-6, -2. Parametric statistical methods were used.

Results. The level of blood leptin in patients with LS was significantly higher than in patients without steatosis (26.09 ng/mL and 15.45 ng/mL, p=0.05), it could be due to a higher body weight (body mass index 33.47 and 28.72 kg/m²; p<0.05), but not to abdominal obesity. Insulin level in the blood of LS patients was significantly higher (30.25 and 21.77 μU/mL, p<0.01) in patients with elevated leptin level (43.10 ng/mL). According correlation analysis, further increase in the already elevated leptin was significantly associated with longer history of diabetes (r=0.73), increasing endogenous intoxication by creatinine (r=0.70), and lipid distress by low-density lipoprotein cholesterol (r=0.76), all p<0.05. In patients with comorbid LS, the blood resistin level was similar to that in patients without steatosis, and its level significantly correlated with the expression of both proinflammatory cytokines (with TNF-alpha: r=0.50; p<0.05 and IL-2: r=0.62; p<0.01), also patients with above-average resistin level had theirs significantly higher levels (IL-2: 8.52 vs 4.82 pg/mL; TNF-alpha: 9.10 vs 5.51 pg/mL, both p<0.05).

Conclusion. Comorbid nonalcoholic fatty liver steatosis was associated with a significant increase in leptin level and had no effect on resistin level. Increased resistin level was associated with high pro-inflammatory parameters such as TNF-alpha and IL-2, which may be a marker of onset of steatohepatitis.