Monday, November 25, 2013

status of HGF, adiponectin levels and histopathology of liver in NASH.

Journal of the association of physicians of india • november 2013 • VOL . 61 15
Objectives: Hepatocyte growth factor (HGF) and Adiponectin are adipokines. Serum HGF and adiponectin
levels are strongly associated with liver disease, obesity, insulin resistance and metabolic syndrome (MS).
Non alcoholic steatohepatitis (NASH) is the hepatic component of metabolic syndrome. Our aim was to
elucidate the status of HGF, adiponectin levels and histopathology of liver in NASH.
Methods: This study was conducted among 50 subjects (25 patients and 25 controls) age and sex matched
attending OPD. Patients were randomly selected for the study and after explaining in detail design of the
study, written consent was taken. Institutional ethical approval was also taken. The only diagnostic method
for NASH is liver biopsy (after exclusion of other causes based upon clinical examination and laboratory
investigations) and pathological grading and staging was done according to Brunt classification. Diagnosis
of patients was done on the basis of liver biopsy and fasting HGF and adiponectin were performed with
commercially available ELISA kits (quantikine HGF and adiponectin ELISA kits).
Results: Mean serum HGF in patient and control groups were 2.33 ± 0.66 pg/ml and 0.56 ± 0.21 pg/ml
respectively (p < 0.001). Mean serum adiponectin in patient and control groups were 6.93 ± 1.50 ng/ml
and 14.54 ± 3.58 ng/ml respectively (p < 0.001). Multiple regression analysis revealed that statistically
significant difference was found (p < .001) when comparing mean brunt grade and brunt stage (hepatic
histopathology) with fasting serum adiponectin and HGF
Conclusion: Fasting serum HGF was significantly high and fasting serum adiponectin was significantly low
in patients of various grades of hepatic histopathology in NASH. Various parameters of MS were significantly
correlated with various stages of hepatic histopathology, as well as decreased serum adiponectin and
increased fasting serum HGF.
*Professor, **Sr. Resident,
***Associate Professor, ****Sr.
Registrar, †Assistant Professor,
Diabetes Care and Research
Centre, S.P. Medical College,
Received: 14.02.2012;
Revised: 15.06.2012;
Re-revised: 10.07.2012;
Accepted: 12.07.2012
NASH is considered to be the hepatic
component of metabolic syndrome.
All of the predictors of progression of
fibrosis in patients with NASH such
as age (> 45 year old), obesity ([body
mass index] BMI ≥ 30 kg/m2), fibrosis or
cirrhosis (AST/ALT > 1), and diabetes,
are associated with increased Insulin
Resistance (IR).1 As a result, even though
non-alcoholic steatohepatitis (NASH)
is a multifactorial disease, IR seems to
be the main factor that is responsible
Hepatocyte Growth Factor, Adiponectin and
Hepatic Histopathology in Non-Alcoholic
RP Agrawal*, Vikas Sheroan**, Vipin Ola**, AA Sulemani***, Neetu Singh***,
P Sirohi***, Sunil Gothwal****, Jai Kumar