Adiponectin as a biomarker in liver cirrhosis-A systematic review and meta-analysis.

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL European Journal of Clinical Investigation Pub Date : 2024-11-02 DOI:10.1111/eci.14328

Abdulrahman Ismaiel, Vera Ciornolutchii, Thelva Esposito Herrera, Mohamed Ismaiel, Daniel-Corneliu Leucuta, Stefan-Lucian Popa, Dan L Dumitrascu

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Abstract

Introduction: Adiponectin, a key adipokine, shows promise as a non-invasive biomarker for liver cirrhosis by reflecting inflammation and metabolic changes, but conflicting findings highlight the need for a systematic review and meta-analysis to clarify its role. Our study aimed to evaluate adiponectin levels across various stages of liver cirrhosis, compare them with other chronic liver diseases (CLD) and hepatocellular carcinoma (HCC), and assess its potential as a diagnostic and prognostic biomarker.

Methods: Our systematic search was conducted on September 2023 using PubMed, EMBASE and Scopus, searching for observational studies evaluating serum and plasma adiponectin levels in liver cirrhosis. Inclusion and exclusion criteria were applied, and study quality was assessed using the Newcastle-Ottawa Scale. To evaluate the overall effect size, we utilized a random-effects model along with a mean difference (MD) analysis. The principal summary outcome was the MD in adiponectin levels.

Results: We included 16 articles involving 2617 subjects in our qualitative and quantitative synthesis. We found significantly higher adiponectin levels in liver cirrhosis patients (8.181 [95% CI 3.676, 12.686]), especially in Child-Pugh B individuals (13.294 [95% CI 4.955, 21.634]), compared to controls. Child-Pugh A patients did not show significant differences compared to controls. In addition, adiponectin levels were significantly elevated in primary biliary cholangitis (PBC) patients compared to controls (8.669 [95% CI .291, 17.047]), as well as in liver cirrhosis compared to other CLD patients (4.805 [95% CI 1.247, 8.363]), including non-alcoholic fatty liver disease (NAFLD) (8.532 [95% CI 3.422, 13.641]), but not viral hepatitis. No significant MD was observed between liver cirrhosis and HCC patients.

Conclusion: Adiponectin levels are significantly elevated in liver cirrhosis, especially in advanced stages, potentially serving as a biomarker for advanced cirrhosis. Adiponectin also differentiates cirrhosis from other CLD, including NAFLD. However, its role in distinguishing cirrhosis from viral hepatitis and HCC is limited.

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作为肝硬化生物标志物的脂肪连接蛋白--系统综述和荟萃分析。

简介脂联素是一种关键的脂肪因子，通过反映炎症和代谢变化，有望成为肝硬化的非侵入性生物标志物，但研究结果相互矛盾，因此需要进行系统回顾和荟萃分析以明确其作用。我们的研究旨在评估肝硬化不同阶段的脂肪连蛋白水平，将其与其他慢性肝病（CLD）和肝细胞癌（HCC）进行比较，并评估其作为诊断和预后生物标志物的潜力：我们于 2023 年 9 月使用 PubMed、EMBASE 和 Scopus 进行了系统性检索，搜索评估肝硬化患者血清和血浆脂肪连蛋白水平的观察性研究。研究采用了纳入和排除标准，并使用纽卡斯尔-渥太华量表对研究质量进行了评估。为了评估总体效应大小，我们采用了随机效应模型和平均差（MD）分析。主要的总结性结果是脂肪连素水平的 MD：我们在定性和定量综述中纳入了 16 篇文章，涉及 2617 名受试者。我们发现，与对照组相比，肝硬化患者（8.181 [95% CI 3.676, 12.686]），尤其是 Child-Pugh B 患者（13.294 [95% CI 4.955, 21.634]）的脂肪连素水平明显更高。Child-Pugh A 患者与对照组相比没有明显差异。此外，原发性胆汁性胆管炎（PBC）患者与对照组相比（8.669 [95% CI .291, 17.047]），肝硬化患者与其他 CLD 患者相比（4.805 [95% CI 1.247, 8.363]），包括非酒精性脂肪肝（NAFLD）患者（8.532 [95% CI 3.422, 13.641]），脂肪连素水平均显著升高，但病毒性肝炎患者不升高。在肝硬化和 HCC 患者之间没有观察到明显的 MD：结论：肝硬化患者，尤其是晚期肝硬化患者的脂肪连接蛋白水平明显升高，有可能成为晚期肝硬化的生物标志物。脂肪连接蛋白还能区分肝硬化和其他慢性疾病，包括非酒精性脂肪肝。但是，它在区分肝硬化与病毒性肝炎和 HCC 方面的作用有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.