Endocrine Abstracts

Aim: The aim of the study was to evaluate the relation between anthropometric measurements, plasma biomarkers of inflammation, metabolic and adipokines pattern and the presence of severe steatosis, in a group of patients with morbid obesity.

Materials and methods: We evaluated a group of 40 patients (25 F, 15 M) with morbid obesity and indication for bariatric surgery. Anthropometric measurements (waist circumference, BMI determination) were performed and the presence and the degree of hepatic steatosis, right lobe diameter (measured by abdominal ultrasound), markers of inflammation (hs C reactive protein, fibrinogen, IL6), insulin resistance (homeostasis model assessment-HOMA) and adiponectin level (ELISA method) were evaluated. According to US results, the patients were divided in a group with severe steatosis (17 patients) and a group with apparently normal structure or lesser degrees of steatosis (13 patients).

Results: Obese patients with severe steatosis had significantly higher waist circumference (137.7 vs 112.42 mm, P<0.01), liver right lobe diameter (193.8 vs 153.9 mm, P<0.001), HOMA (9.32 vs 4.07, P<0.01) and lower levels of adiponectin (14.15 vs 20.40 ng/ml, P<0.05) than those without severe steatosis, independently of the BMI. In all patients, right lobe transverse diameter was positively correlated with the level of plasma CRP (r=0.535, P<0.05), triglycerides (r=0.4, P<0.05), liver enzymes and GGT level. Patients with severe steatosis showed a higher prevalence of metabolic syndrome (ATP III criteria – 63% vs 50%, P<0.05).

Conclusions: These results show that severe steatosis is closely related with a modified plasma lipid and pro-inflammatory profile, as well as with markers of insulin resistance (HOMA). Adiponectin levels were significantly lower in patients with severe steatosis than in patients with lesser degrees of fatty liver. Further studies are needed in order to establish a direct causality effect between this alterations and liver changes in severely obese patients.