Background: Pathologically, hepatic changes are common in morbidly obese patients. Insulin resistance impacts the pathogenesis of non-alcoholic fatty liver disease and may potentiate the progression of non-alcoholic steatohepatits and fibrosis. This study investigates the impact of leptin and adiponectin in morbidly obese diabetic and non-diabetic patients with regards to histopathological hepatic changes.
Methods: Twenty morbidly obese patients undergoing bariatric surgery with liver biopsy were enrolled in the study. All patients were obese with a BMI greater than 35. Six were diabetic and fourteen were non-diabetic. Liver tissue, obtained intra-operatively, was flash frozen in liquid nitrogen. Total RNA was extracted with Trizol and the RNA was purified (Qiagen). RNA was reverse transcribed to cDNA using the iScript cDNA synthesis kit (Biorad), and real time quantitative PCR was performed to determine relative gene expression. The data were analyzed using a logarithmic transformation and normalization with 18s.
Results: In liver, there is an over expression of leptin in the diabetic patients by a factor of 1.72 ± 0.74 (p value less than 0.05). Leptin expression in patients with steatotic changes showed a down regulation by a factor of 1.3± 1.9 (p=0.2). Adiponectin levels were over-expressed in diabetic patients with and without steatosis by 4.6 ± 3.1(p value less than 0.05). A student t-test was used for statistical analysis.
Conclusions: To date there is limited data regarding adiponectin and leptin expression in hepatic tissue. This study illustrates an association between altered adiponectin and leptin levels with hepatic steatosis in diabetic patients. This interesting correlation is currently undergoing investigation with an established line of hepatic stellate cells to elucidate the mechanisms of steatosis and diabetes.
Session: Podium Presentation
Program Number: S048