Circulating adiponectin levels in HCV correlated chronic active hepatitis (CAH) and cirrhosis

Adiponectin is a hormone secreted by adipocytes with anti-diabetic and anti-atherogenic properties. Levels of adiponectin are decreased in the blood under conditions of obesity, insulin-resistance and type 2 diabetes. HCV-related CAH and cirrhosis have been associated to insulin resistance and impared glucose tollerance. We measured circulating adiponectin lev- els in 35 non-diabetic patients with CAH (9 females, 26 males; BMI 24.7±3.9 kg/m 2 , mean±SD), 17 patients with CHILD-A cirrhosis (4 fe- males, 13 males; 25.0±3.8 kg/m 2 ) and 32 healthy subjects matched for sex and BMI. Evaluation of fasting glucose, insulin and homeostasis model as- sessments for insulin resistance (HOMA-IR) was performed in all patients and controls. Insulin resistance, as elevated HOMA-IR, was present in 57% of CAH and 72% of cirrhosis. Circulating adiponectin levels were higher both in CAH and cirrhotic patients than in control subjects (24.0±3.3 and 14.3±7.7 vs 9.5±3.8 mg/L; P<0.01). Gender difference was present both in CAH and cirrhotic patients (13.4±5.0 vs 18.7±3.6 mg/L and 13.2±4.2 vs 20.5±11.6 mg/L, males vs females; P<0.01), while the correlation with BMI observed in controls was lost. Patients with CAH associated to NASH showed adiponectin levels lower than CAH patients without NASH (19.7±5.8 vs 24.0±3.3 mg/L; P<0.05). In cirrhotic patients adiponectin levels were lower than in CAH patients (14.4±7.7 vs 24.0±3.3 mg/L; P<0.01). In conclusion, our study shows that liver disease is associated to insulin resistance and unexpectedly to elevated adiponectin levels. Though adiponectin is exclusively produced by adipocytes, hyperadiponectinemia might be the consequence of liver inflammation or alternatively of liver resistance to adiponectin action.