Expression and significance of leptin and adiponectin in serum of patients with nonalcoholic fatty liver disease and coronary heart disease

Objective To investigate the expression of leptin( LEP) and adiponectin( ADPN) in the serum of patients with nonalcoholic fatty liver disease( NAFLD) and coronary heart disease( CHD) and the association of LEP and ADPN with NAFLD and CHD. Methods A total of 83 patients with NAFLD,86 patients with NAFLD and CHD,and 69 healthy individuals,who attended Qingdao Municipal Hospital from October 2018 to August 2019,were enrolled as NAFLD group,NAFLD + CHD group,and healthy control group,respectively.Clinical data and blood samples were collected; ELISA was used to measure the serum levels of LEP and ADPN,and an automatic biochemical analyzer was used to investigate liver function. An analysis of variance was used for comparison of normally distributed continuous data between three groups,and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between three groups. The chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used to investigate the association of LEP,ADPN,and other related indices with NAFLD or NAFLD with CHD,and a Pearson correlation analysis was used to investigate the correlation of LEP and ADPN with other indices. Results The NAFLD group had a significantly higher serum level of LEP and a significantly lower serum level of ADPN than the healthy control group( both P < 0. 05); the NAFLD + CHD group had a significantly higher serum level of LEP and a significantly lower serum level of ADPN than the NAFLD group( both P < 0. 05); the NAFLD + CHD group had a significantly higher serum level of LEP and a significantly lower serum level of ADPN than the healthy control group( both P < 0. 05). Body mass index( BMI)( odds ratio [OR]=23. 564,95% confidence interval [CI]: 2. 696-205. 919,P < 0. 05),fasting blood glucose( OR = 5. 559,95% CI: 1. 030-29. 996,P < 0. 05),triglyceride( OR = 7. 740,95% CI: 1. 379-43. 426,P < 0. 05),high-density lipoprotein( OR = 0. 072,95% CI: 0. 019-0. 268,P < 0. 05),LEP( OR = 17. 549,95% CI: 2. 344-131. 357,P < 0. 05),and ADPN( OR = 0. 182,95% CI: 0. 043-0. 760,P < 0. 05) were all associated with the risk of NAFLD,and BMI( OR = 11. 561,95% CI: 4. 828-27. 682,P < 0. 05),LEP( OR =19. 804,95% CI: 2. 476-158. 402,P < 0. 05),and ADPN( OR = 0. 025,95% CI: 0. 005-0. 121,P < 0. 05) were all associated with the risk of CHD. In the NAFLD group,the serum level of ADPN was positively correlated with low-density lipoprotein( r = 0. 251,P =0. 022),and in the NAFLD + CHD group,the serum level of LEP was positively correlated with BMI( r = 0. 241,P = 0. 025). Conclusion Hypoadiponectinemia and hyperleptinemia are not only the risk factors for NAFLD,but they may also increase the risk of CHD in NAFLD patients,and BMI is the basis for the association between the abnormal expression of leptin and the risk of CHD in NAFLD.