Relationship between insulin resistance, inflammation and liver cell apoptosis in patients with severe obesity.

Abstract

BACKGROUND:

In obesity, insulin resistance appears frequently after activation of proinflammatory molecules. Caspase-generated cytokeratin-18 (CK-18) fragments are produced during the apoptosis of hepatic cells. The main objective in the present study is to investigate the relationship between insulin resistance and caspase-generated CK-18 fragments in patients with severe obesity.

METHODS:

Sixty-two patients selected for bariatric surgery were clinically studied (sex, age, weight, waist diameter, body mass index, arterial pressure and type 2 diabetes mellitus) and analytic parameters were measured in blood (glucose concentration, cholesterol, triglycerides, insulin, glycosylated hemoglobin, aspartate aminotransferase, alanine aminotransferase, high-sensitivity C-reactive protein, adiponectin, interleukin 6, interleukin 18 and CK-18 fragments). Patient group division was based on 70th percentile of insulin resistance as measured by homeostasis model assessment (HOMA) and also according to liver histology.

RESULTS:

Patients with greater insulin resistance (percentile > 70th) showed higher values of CK-18 fragments, interleukin 6 and transaminases. A positive correlation between the HOMA score, value of CK-18 fragments and triglyceride level was found. A correlation between CK-18 fragments with interleukin 6, triglycerides and transaminases was also observed. HOMA score and value of CK-18 fragments correlated with the degree of liver fibrosis.

CONCLUSIONS:

Greater degree of insulin resistance induces apoptosis of hepatic cells as measured by the serum levels of CK-18 fragments.

• Authors: M Civera, A Urios, M L Garcia-Torres, J Ortega, J Martinez-Valls, N Cassinello, J A del Olmo, A Ferrandez, J M Rodrigo, C Montoliu
• Journal: Diabetes/metabolism research and reviews (Diabetes Metab Res Rev) Vol. 26 Issue 3 Pg. 187-92 (Mar 2010) ISSN: 1520-7560 [Electronic] England
• PMID: 20222158 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 John Wiley & Sons, Ltd.

Chemical References

• Blood Glucose
• Insulin
• Interleukin-18
• Interleukin-6
• Keratin-18
• Lipids

Topics

• Adult
• Apoptosis (physiology)
• Blood Glucose
• Blood Pressure
• Body Mass Index
• Enzyme-Linked Immunosorbent Assay
• Female
• Fibrosis (pathology)
• Hepatocytes (metabolism, pathology)
• Humans
• Inflammation (metabolism, pathology)
• Insulin (blood)
• Insulin Resistance (physiology)
• Interleukin-18 (blood)
• Interleukin-6 (blood)
• Keratin-18 (blood)
• Lipids (blood)
• Liver (pathology)
• Male
• Middle Aged
• Obesity (metabolism, pathology)
• Odds Ratio
• Patient Selection
• Statistics, Nonparametric