- Email: [email protected]
1034 PLASMA LEVELS OF SOLUBLE RECEPTOR FOR ADVANCED GLYCATION ENDPRODUCTS (SRAGE) IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE
S374
Poster Session − Saturday, April 25
dose. However, recent reports suggest that liver fibrosis may be less prevalent than what early data showed.Our aim is to establish the prevalence of liver fibrosis in an Asian psoriatic population on MTX and to evaluate the possible risk factors. Methods: We retrospectively reviewed the clinical data and liver biopsies of psoriatic patients referred to our institution from January 2000 to December 2006. Histological changes were staged according to ‘Roengik score’. Statistical analysis was performed using Stata V.9.2. The study was approved by Research Ethics Committee of National Healthcare Group. Results: There were 60 patients receiving a total of 101 liver biopsies. Of the 98 available biopsy reports, 5.9% were normal (median cumulative dose 2285 mg); 61.4% revealed Grade I changes (median cumulative dose 2885 mg); 22.8% revealed Grade II changes (median cumulative dose 1800 mg); 6.9% revealed Grade III changes (median cumulative dose 1500 mg) and none revealed Grade IV change. The prevalence of liver fibrosis (Grade III) was 12%. Cumulative MTX dose was not associated with liver fibrosis, the only significant risk factors were diabetes and hypertension (p = 0.005 and 0.006 respectively). 40 patients without either risk factor had no fibrosis (median cumulative dose 3000 mg); and 7 of the 19 patients (37%) with at least one risk factor developed liver fibrosis (median cumulative dose 1500 mg). Conclusions: The prevalence of liver fibrosis in our Asian psoriatic population on MTX was low. Cumulative MTX dose was not associated with liver fibrosis. Diabetes and hypertension were significant risk factors. Current recommendations of regular liver biopsies may need to be reviewed, especially in patient without risk factor for liver disease. 1034 PLASMA LEVELS OF SOLUBLE RECEPTOR FOR ADVANCED GLYCATION ENDPRODUCTS (SRAGE) IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE Y. Yilmaz1 , E. Ulukaya2 , O.O. Gul3 , M. Arabul4 , C.B. Gul4 , O. Atug1 , A.Y. Oral2 , E. Dolar5 . 1 Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, 2 Department of Biochemistry, 3 Department of Endocrinology, 4 Department of Internal Medicine, 5 Department of Gastroenterology, Uludag University Medical School, Bursa, Turkey E-mail: [email protected] Levels of soluble receptor for advanced glycation endproducts (sRAGE) have been recently linked to insulin resistance and several components of the metabolic syndrome (MetS). Since nonalcoholic fatty liver disease (NAFLD) is currently regarded as the hepatic manifestation of the MetS, the study of plasma levels of sRAGE in relation to the presence and the characteristics of NAFLD seemed worthy of investigation. Four group of patients were enrolled in the present study: subjects with definite nonalcoholic steatohepatitis (NASH, n = 40), borderline NASH (n = 8), simple fatty liver (n = 9) and healthy controls without evidence of liver disease (n = 14). Circulating levels of sRAGE were measured in EDTA-plasma by ELISA (R&D systems). Concentrations of sRAGE were significantly lower in patients with definite NASH (1085±397 pg/mL, p < 0.01) and borderline NASH (1079±466 pg/mL, p < 0.05) compared to control subjects (1380±475 pg/mL). No significant difference were found in patients with simple fatty liver as compared to controls. Notably, levels of sRAGE in patients with definite and borderline NASH were significantly and inversely correlated with ALT (r = −0.30, p < 0.05) and AST (r = −0.23, p < 0.05), but not with histological staging and pathological characteristics of NASH. In conclusion, levels of sRAGE are significantly reduced in the setting of the most severe forms of NAFLD (definite and borderline NASH) but not in subjects with simple steatosis. Our results confirm previous data on the possible inverse association of sRAGE with serum aminotransferases. Further studies are warranted on sRAGE as a potential biomarker of liver disease.
1035 DIFFERENCES OF ADIPOCYTOKINE BETWEEN NONALCOHOLIC FATTY LIVER DISEASE AND CORONARY ARTERY DISEASE A. Baranova1,2,3 , I. Kaur1,3 , N. Hossain1,3 , M. Randhawa2,3 , V. Chandhoke2,3 , Z. Younossi1,2,3 . 1 Center for Liver Disease, Inova Fairfax Hospital, Inova Health System, 2 Center for the Study of Genomics in Liver Diseases, Molecular and Microbiology Department, George Mason University, VA, USA; 3 Center for Integrated Research, Inova Health System, Falls Church, VA, USA E-mail: [email protected] Background and Aims: Metabolic syndrome (MS) is associated with both coronary artery disease (CAD) and non-alcoholic fatty liver disease (NAFLD). Recent data suggest that adipokines and cytokines play an important role in the development of both complications of the MS. In this study, we attempted to identify differences of adipokines and cytokine between two important complications of MS (NAFLD and CAD). Methods: This study included 120 patients. Of this cohort, 25 with proven CAD were undergoing coronary artery bypass grafting. Of NAFLD cohort (N = 45), 28 had biopsy-proven NASH. We used 50 patients without known CAD or NAFLD as controls. HOMA scores and BMI were used for matching both CAD and NAFLD cohorts with controls. For the entire cohort, fasting serum was assayed for adiponectin, resistin, insulin, glucose, visfatin, TNF-alpha and IL-6. Non-parametric analyses were performed to compare the adipokine and cytokine levels and used to calculate Pearson’s correlations. Results: Overall, resistin levels were higher in CAD as compared to NASH (8.99±4.96 vs. 6.09±2.92, p < 0.01) or to NAFLD (8.99±4.96 vs. 6.94±3.65, p < 0.05). Only, in patients with CAD, resistin positively correlated with adiponectin (R = 0.76, p < 1.93×10−5 ). Since BMI is a known confounder for IR and adipocytokines, levels of adipokines and cytokines were normalized to BMI. In fact, ratios of BMI to resistin were substantially lower in NAFLD group as compared to both CAD (1.76±1.88 vs. 3.77±1.62, p < 7.72816×10−6 ) and to controls (1.76±1.88 vs. 7.60±3.6, p < 3.3598×10−6 ). Furthermore, ratios of BMI to adiponectin were higher in NAFLD as compared to CAD (9.30±7.40 vs. 4.79±2.16, p < 0.004), but not to controls (9.30±7.40 vs. 6.56±3.92, p = NS). Conclusions: Resistin and adiponectin may play important but different role in the development of NAFLD versus CAD. Adjustment for BMI is essential in analysis of these soluble adipocytokine levels for patients with metabolic syndrome. 1036 INFLUENCE OF HEPATIC STEATOSIS ON THE APOB/A1 RATIO IN MALE PATIENTS WITH PREDIABETES J. Yun, Y. Cho, J. Park, H. Kim, D. Park, C. Sohn, W. Jeon, B. Kim. Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea E-mail: [email protected] Background and Objective: The ApoB/A1 ratio has been associated with the metabolic syndrome; an increased ApoB/A1 ratio is superior to cholesterol levels for the prediction of cardiovascular events. The goal of our study was to determine the clinical implications of fatty liver disease in male patients with prediabetes, and to examine its effect on predictors of artherosclerosis such as abnormal lipids and the ApoB/A1 ratio. Methods: There were 1,366 patients (977 males and 389 females) diagnosed with prediabetes or diabetes. The criterion for IFG was fasting plasma glucose of 100–125 mg/dL, and that for IGT was plasma glucose of 140–199 mg/dL two hours after oral glucose loading. Measurements studied were lipid profiles including lipoprotein and apolipoprotein, the factors associated with the metabolic syndrome (waist circumference, body mass index (BMI), systolic/diastolic blood pressure, and HOMA-IR) as well as fasting glucose, insulin, and the calculated ApoB/A1 ratio. Results: Among the 1,366 patients, 952 (70%) were diagnosed with prediabetes [IFG:511(54%), IGT:27(2%), IFG+IGT: 416(44%)], and 414 (30%) with diabetes. When each group was subdivided by the presence of
Poster Session − Saturday, April 25
dose. However, recent reports suggest that liver fibrosis may be less prevalent than what early data showed.Our aim is to establish the prevalence of liver fibrosis in an Asian psoriatic population on MTX and to evaluate the possible risk factors. Methods: We retrospectively reviewed the clinical data and liver biopsies of psoriatic patients referred to our institution from January 2000 to December 2006. Histological changes were staged according to ‘Roengik score’. Statistical analysis was performed using Stata V.9.2. The study was approved by Research Ethics Committee of National Healthcare Group. Results: There were 60 patients receiving a total of 101 liver biopsies. Of the 98 available biopsy reports, 5.9% were normal (median cumulative dose 2285 mg); 61.4% revealed Grade I changes (median cumulative dose 2885 mg); 22.8% revealed Grade II changes (median cumulative dose 1800 mg); 6.9% revealed Grade III changes (median cumulative dose 1500 mg) and none revealed Grade IV change. The prevalence of liver fibrosis (Grade III) was 12%. Cumulative MTX dose was not associated with liver fibrosis, the only significant risk factors were diabetes and hypertension (p = 0.005 and 0.006 respectively). 40 patients without either risk factor had no fibrosis (median cumulative dose 3000 mg); and 7 of the 19 patients (37%) with at least one risk factor developed liver fibrosis (median cumulative dose 1500 mg). Conclusions: The prevalence of liver fibrosis in our Asian psoriatic population on MTX was low. Cumulative MTX dose was not associated with liver fibrosis. Diabetes and hypertension were significant risk factors. Current recommendations of regular liver biopsies may need to be reviewed, especially in patient without risk factor for liver disease. 1034 PLASMA LEVELS OF SOLUBLE RECEPTOR FOR ADVANCED GLYCATION ENDPRODUCTS (SRAGE) IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE Y. Yilmaz1 , E. Ulukaya2 , O.O. Gul3 , M. Arabul4 , C.B. Gul4 , O. Atug1 , A.Y. Oral2 , E. Dolar5 . 1 Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, 2 Department of Biochemistry, 3 Department of Endocrinology, 4 Department of Internal Medicine, 5 Department of Gastroenterology, Uludag University Medical School, Bursa, Turkey E-mail: [email protected] Levels of soluble receptor for advanced glycation endproducts (sRAGE) have been recently linked to insulin resistance and several components of the metabolic syndrome (MetS). Since nonalcoholic fatty liver disease (NAFLD) is currently regarded as the hepatic manifestation of the MetS, the study of plasma levels of sRAGE in relation to the presence and the characteristics of NAFLD seemed worthy of investigation. Four group of patients were enrolled in the present study: subjects with definite nonalcoholic steatohepatitis (NASH, n = 40), borderline NASH (n = 8), simple fatty liver (n = 9) and healthy controls without evidence of liver disease (n = 14). Circulating levels of sRAGE were measured in EDTA-plasma by ELISA (R&D systems). Concentrations of sRAGE were significantly lower in patients with definite NASH (1085±397 pg/mL, p < 0.01) and borderline NASH (1079±466 pg/mL, p < 0.05) compared to control subjects (1380±475 pg/mL). No significant difference were found in patients with simple fatty liver as compared to controls. Notably, levels of sRAGE in patients with definite and borderline NASH were significantly and inversely correlated with ALT (r = −0.30, p < 0.05) and AST (r = −0.23, p < 0.05), but not with histological staging and pathological characteristics of NASH. In conclusion, levels of sRAGE are significantly reduced in the setting of the most severe forms of NAFLD (definite and borderline NASH) but not in subjects with simple steatosis. Our results confirm previous data on the possible inverse association of sRAGE with serum aminotransferases. Further studies are warranted on sRAGE as a potential biomarker of liver disease.
1035 DIFFERENCES OF ADIPOCYTOKINE BETWEEN NONALCOHOLIC FATTY LIVER DISEASE AND CORONARY ARTERY DISEASE A. Baranova1,2,3 , I. Kaur1,3 , N. Hossain1,3 , M. Randhawa2,3 , V. Chandhoke2,3 , Z. Younossi1,2,3 . 1 Center for Liver Disease, Inova Fairfax Hospital, Inova Health System, 2 Center for the Study of Genomics in Liver Diseases, Molecular and Microbiology Department, George Mason University, VA, USA; 3 Center for Integrated Research, Inova Health System, Falls Church, VA, USA E-mail: [email protected] Background and Aims: Metabolic syndrome (MS) is associated with both coronary artery disease (CAD) and non-alcoholic fatty liver disease (NAFLD). Recent data suggest that adipokines and cytokines play an important role in the development of both complications of the MS. In this study, we attempted to identify differences of adipokines and cytokine between two important complications of MS (NAFLD and CAD). Methods: This study included 120 patients. Of this cohort, 25 with proven CAD were undergoing coronary artery bypass grafting. Of NAFLD cohort (N = 45), 28 had biopsy-proven NASH. We used 50 patients without known CAD or NAFLD as controls. HOMA scores and BMI were used for matching both CAD and NAFLD cohorts with controls. For the entire cohort, fasting serum was assayed for adiponectin, resistin, insulin, glucose, visfatin, TNF-alpha and IL-6. Non-parametric analyses were performed to compare the adipokine and cytokine levels and used to calculate Pearson’s correlations. Results: Overall, resistin levels were higher in CAD as compared to NASH (8.99±4.96 vs. 6.09±2.92, p < 0.01) or to NAFLD (8.99±4.96 vs. 6.94±3.65, p < 0.05). Only, in patients with CAD, resistin positively correlated with adiponectin (R = 0.76, p < 1.93×10−5 ). Since BMI is a known confounder for IR and adipocytokines, levels of adipokines and cytokines were normalized to BMI. In fact, ratios of BMI to resistin were substantially lower in NAFLD group as compared to both CAD (1.76±1.88 vs. 3.77±1.62, p < 7.72816×10−6 ) and to controls (1.76±1.88 vs. 7.60±3.6, p < 3.3598×10−6 ). Furthermore, ratios of BMI to adiponectin were higher in NAFLD as compared to CAD (9.30±7.40 vs. 4.79±2.16, p < 0.004), but not to controls (9.30±7.40 vs. 6.56±3.92, p = NS). Conclusions: Resistin and adiponectin may play important but different role in the development of NAFLD versus CAD. Adjustment for BMI is essential in analysis of these soluble adipocytokine levels for patients with metabolic syndrome. 1036 INFLUENCE OF HEPATIC STEATOSIS ON THE APOB/A1 RATIO IN MALE PATIENTS WITH PREDIABETES J. Yun, Y. Cho, J. Park, H. Kim, D. Park, C. Sohn, W. Jeon, B. Kim. Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea E-mail: [email protected] Background and Objective: The ApoB/A1 ratio has been associated with the metabolic syndrome; an increased ApoB/A1 ratio is superior to cholesterol levels for the prediction of cardiovascular events. The goal of our study was to determine the clinical implications of fatty liver disease in male patients with prediabetes, and to examine its effect on predictors of artherosclerosis such as abnormal lipids and the ApoB/A1 ratio. Methods: There were 1,366 patients (977 males and 389 females) diagnosed with prediabetes or diabetes. The criterion for IFG was fasting plasma glucose of 100–125 mg/dL, and that for IGT was plasma glucose of 140–199 mg/dL two hours after oral glucose loading. Measurements studied were lipid profiles including lipoprotein and apolipoprotein, the factors associated with the metabolic syndrome (waist circumference, body mass index (BMI), systolic/diastolic blood pressure, and HOMA-IR) as well as fasting glucose, insulin, and the calculated ApoB/A1 ratio. Results: Among the 1,366 patients, 952 (70%) were diagnosed with prediabetes [IFG:511(54%), IGT:27(2%), IFG+IGT: 416(44%)], and 414 (30%) with diabetes. When each group was subdivided by the presence of