ECE2011 Poster Presentations Obesity (47 abstracts)
Serum homocysteine levels in patients with nonalcoholic fatty liver disease
S A Polyzos 1 , J Kountouras 1 , K Patsiaoura 2 , E Katsiki 2 , E Zafeiriadou 3 , G Deretzi 4 , C Zavos 1 , E Gavalas 1 , V Mane 5 & A Slavakis 5
1Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece; 2Department of Pathology, Ippokration Hospital, Thessaloniki, Greece; 3Department of Radiology, Ippokration Hospital, Thessaloniki, Greece; 4Department of Neurology, Papageorgiou Hospital, Thessaloniki, Greece; 5Department of Biochemistry, Ippokration Hospital, Thessaloniki, Greece.
Introduction: High serum homocysteine (Hcy) has been associated with insulin resistance (IR) syndrome and cardiovascular risk, although controversy exists. Nonalcoholic fatty liver disease (NAFLD) is regarded as the hepatic component of IR syndrome, but data on Hcy are limited. The aim of this cross-sectional study was to evaluate serum Hcy levels in patients with NAFLD.
Methods: Thirty-one consecutive patients (54±11years, 8 males) with biopsy-proven NAFLD, 15 of whom with simple nonalcoholic fatty liver (NAFL) and 16 with nonalcoholic steatohepatitis (NASH) according to NAFLD activity score (NAS) histologic system, were recruited. Twenty-two healthy controls (52±9 years, 5 males) matched for gender, age and body mass index (BMI) served as controls. Blood samples for Hcy, folate, vitamin B12, insulin and standard biochemical tests were obtained after overnight fasting. Homeostatic model of assessment-insulin resistance (HOMA-IR) was calculated.
Results: The BMI of NAFLD patients was 33.1±5.3 kg/m2. There was no difference in mean serum Hcy levels between controls and NAFLD patients (12.6±4.6 vs 13.5±2.6 mmol/l, respectively; P=0.432). Serum folate and vitamin B12 were also similar between the study groups. As expected, NAFLD patients had higher ALT (P<0.001), γ-gt (P=0.001), glucose (P=0.001), insulin (P=0.002) and HOMA-IR (P=0.001). However, NASH patients had lower mean serum HCY levels compared with NAFL patients (14.7±2.1 vs 12.3±2.5 mmol/l; P=0.006). Mean age, BMI, serum folate, vitamin B12 ALT, ggt, glucose, insulin and HOMA-IR did not differ between NAFL and NASH patients. In multiple logistic regression analysis, HCY independently predicted NASH (P=0.049) after adjustment for age, BMI and HOMA-IR.
Conclusions: Our data suggest that serum Hcy levels are similar between NAFLD patients and controls, but decreased in NASH compared with NAFL patients and can independently predict NASH. Serum Hcy could probably represent another non-invasive marker for the assessment of NAFLD.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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