Increased plasma proneurotensin levels identify NAFLD in adults with and without type 2 diabetes.

Increased plasma proneurotensin levels identify NAFLD in adults with and without type 2 diabetes.

J Clin Endocrinol Metab. 2018 Mar 23;:

Authors: Barchetta I, Cimini FA, Leonetti F, Capoccia D, Di Cristofano C, Silecchia G, Orho-Melander M, Melander O, Cavallo MG

Abstract
Context: Neurotensin (NT) is an intestinal peptide released by fat ingestion and promoting lipids absorption; higher circulating NT levels associate with type 2 diabetes (T2D), obesity and cardiovascular disease. Whether NT is related to non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) has not been fully investigated.
Objective: To study the relationship between plasma proneurotensin1-117 (pro-NT), a stable fragment of the NT precursor hormone, and the presence/severity of NAFLD/NASH and to unravel correlates of increased pro-NT levels.
Design/Setting/Participants: For this cross-sectional study, sixty obese individuals undergoing bariatric surgery for clinical purposes were recruited. The association between pro-NT and NAFLD was further investigated in 260 consecutive subjects referring to our outpatient clinics for metabolic evaluations including liver ultrasonography. Study population underwent complete metabolic characterization; in the obese cohort, liver biopsies were performed during surgery.
Main outcome measures: Plasma pro-NT levels in relation to NAFLD/NASH.
Results: Obese subjects with biopsy-proven NAFLD (53%) had significantly higher plasma pro-NT than those without NAFLD (183.6±81.4 vs 86.7±56.8 pmol/L, p<0.001). Greater pro-NT correlated with NAFLD presence (p<0.001) and severity (p<0.001), age, female gender, insulin-resistance and T2D. Higher pro-NT predicted NAFLD with AUROC=0.836 (C.I.95%:0.73-0.94, p<0.001). Belonging to the highest pro-NT quartile correlated with increased NAFLD risk (OR:2.62; 95%CI:1.08-6.40), after adjustment for confounders. The association between higher pro-NT and NAFLD was confirmed in the second cohort, independently from confounders.
Conclusions: Increased plasma pro-NT levels identify the presence/severity of NAFLD; in dysmetabolic individuals, NT may specifically promote hepatic fat accumulation though mechanisms likely related to increased insulin-resistance.

PMID: 29590379 [PubMed - as supplied by publisher]

https://ift.tt/2Gjl2nc