Telma Erotides da Silva, Mariana Costa-Silva, Carina G. Correa, Giovana Denardin, Maria L. Ayres Alencar, Mara S. Pacheco Honório Coelho, Letícia Muraro-Wildner, Maria Luiza-Bazzo, David A. González-Chica, Esther Buzaglo Dantas-Corrêa, Janaína L. Narciso-Schiavon, Leonardo de Lucca Schiavon
Introduction. Adiponectin and resistin levels are increased in patients with cirrhosis, but it prognostic significance is unknown. We sought to investigate the factors associated with adiponectin and resistin levels and its clinical significance in patients with cirrhosis. Materials and methods. This was a prospective cohort study that included 122 subjects with cirrhosis who attended an outpatient clinic and were initially evaluated in 2012. Serum adiponectin and resistin levels were measured in samples collected in 2012 (adiponectin and resistin) and 2014 (adiponectin). Thirty healthy subjects served as a control group. Results. Higher adiponectin (21.59 ? g/mL vs. 12.52 ?g/mL, P < 0.001) and resistin levels (3.83 ng/mL vs. 2.66 ng/mL, P < 0.001) were observed among patients with cirrhosis compared to controls. Patients classified as Child-Pugh B/C had higher adiponectin levels in relation to Child-Pugh A patients. At second measurement, adiponectin levels increased significantly in non-transplant patients and decreased in liver transplant recipients. Univariate Cox analysis showed that among patients with alcoholic liver disease, adiponectin levels were associated with lower transplant-free survival (HR = 1.034, 95% CI 1.006 - 1.062, P = 0.016). The transplant-free survival was significantly lower among patients with alcoholic liver disease and adiponectin ? 17 ?g/mL (26.55 months, 95% CI 21.40-31.70) as compared to those with levels < 17 ?g/mL (33.76 months, 95% CI 30.70-36.82) (P = 0.045). No relationship was found between the levels of resistin and survival. Conclusion. Adiponectin but not resistin levels were associated with intensity of liver dysfunction and worse prognosis in patients with alcoholic liver disease, suggesting a potential as a prognostic biomarker.
Key words. Adiponectin., Resistin., Liver cirrhosis, End Stage Liver Disease., Alcoholic liver disease., Prognosis.