Increased serum leukocyte cell-derived chemotaxin 2 (LECT2) levels in obesity and fatty liver.

Leukocyte cell-derived chemotaxin 2 (LECT2) is a signaling molecule expressed in the liver and regulated by Wnt/ß-catenin pathways implicated in hepatic metabolism. However, the clinical relevance of LECT2 in obesity and fatty liver is unknown. The objective of this study was to determine whether serum LECT2 levels are affected by of obesity and fatty liver. A cross sectional study comprising 231 Japanese adult subjects were tested for LECT2 using a highly sensitive assay. We evaluated the associations between LECT2 and the anthropometric or clinical markers of obesity and fatty liver. The mean serum LECT2 levels were 43.5 ± 13.6 ng/mL. LECT2 positively correlated with all the anthropometric measures of obesity: body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio (W/Ht). Multiple regression analysis revealed that LECT2 is independently related to γ-glutamyl transpeptidase (γ-GTP), triglyceride, and age in males, whereas in females it was related to the homeostasis model assessment ratio, blood urea nitrogen, high-density lipoprotein cholesterol, and γ-GTP. Receiver operating characteristics curve analyses revealed that LECT2 correlated with obesity [area under the curve (AUC) 0.655, 95% confidence interval (CI) = 0.551-0.758, p = 0.002 in males; AUC 0.670, 95% CI = 0.570-0.770, p < 0.001 in females] and fatty liver (AUC 0.646, 95% CI = 0.544-0.749, p = 0.004 in males; AUC 0.733, 95% CI = 0.621-0.844, p < 0.001 in females). The present study indicates that serum LECT2 levels are increased by obesity and fatty liver, and suggests that LECT2 is a novel obesity-related protein.

Nonalcoholic fatty liver is a risk factor for postprandial hyperglycemia, but not for impaired fasting glucose.

PURPOSE: The first aim of this study was to elucidate the relationship between impaired glucose tolerance (IGT) and nonalcoholic fatty liver. The second was to make a rule regarding to whom 75-g oral glucose tolerance tests (OGTTs) should be applied to identify subjects with IGT and diabetes mellitus (DM) in the annual check-up at the human dry dock. METHODS: A total of 716 subjects who visited the Department of General Medicine of the International Medical Center of Japan from May 2001 through January 2008 for an annual check-up at the human dry dock were analyzed. We evaluated risk factors related to nonalcoholic fatty liver using multivariate logistic regression analysis and compared the difference of body mass index (BMI) and glucose level at 75-g OGTT at two different time points in subjects whose fatty change had improved or worsened. RESULTS: Nonalcoholic fatty liver was strongly related to 2-h- and 1-h-post-challenge glucose level (P<0.0001 and P=0.018, respectively), but not fasting plasma glucose (FPG) (P=0.706). The risk factors for IGT were nonalcoholic fatty liver (P<0.05), low levels of high-density lipoprotein cholesterol (HDL-C) (P=0.026) and age (P=0.013). A clearly positive relationship was observed between the difference of BMI and 2-h-post-challenge glucose level among the subjects whose fatty change had improved or worsened (R=0.6, P=0.018). CONCLUSIONS: Nonalcoholic fatty liver was clearly related to the 2-h- or 1-h-post-challenge glucose level, but not to FPG, in 75-g OGTT, and this IGT was corrected by body weight reduction in accordance with diminished nonalcoholic fatty liver. Thus, 75-g OGTT should be applied to subjects with nonalcoholic fatty liver to evaluate IGT.

High-sensitivity C-reactive protein as a serum predictor of nonalcoholic fatty liver disease based on the Akaike Information Criterion scoring system in the general Japanese population.

BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) has been developed and used as a marker to predict coronary vascular diseases in metabolic syndrome (MS). We investigated whether serum hs-CRP concentration was associated with nonalcoholic fatty liver disease (NAFLD) based on the Akaike Information Criterion (AIC) scoring system, using patients from the human dry dock program. METHODS: From 2004 to 2005, 1254 subjects visited our human dry dock annual checkup program. We excluded from this study individuals with markers of viral hepatitis and those whose alcohol consumption was more than 20 g/week. Finally, 230 subjects (93 men and 137 women) were investigated. Serum hs-CRP concentrations were measured using a highly sensitive latex agglutination assay system. The AIC scoring system with the CATDAP-20 program was introduced to evaluate the parameters that are present frequently in NAFLD. RESULTS: NAFLD was diagnosed by ultrasound sonography in 35.4% of the men and 18.9% of the women. High serum hs-CRP concentrations were observed in women with NAFLD (normal: NAFLD = 0.45:1.47 mg/l, P < 0.05). Body mass index (BMI), waist circumference, and body weight had the three lowest AIC score (P = 4.5e(-19) to 2.6e(-16)). hs-CRP was the third lowest variable among the serum markers associated with NAFLD (P = 2.3e(-6)) In addition, the hs-CRP concentration was correlated strongly with triglyceride values in females with NAFLD and with fasting blood glucose, HbA1c, and waist/hip ratio in males with NAFLD (P < 0.05). CONCLUSIONS: The serum hs-CRP concentration was a strong predictor for NAFLD with a low AIC score and correlated with serum markers that indicated lipid and glucose metabolism.

Clinical significance of fatty liver associated with metabolic syndrome.

AIM: Metabolic syndrome (MS) has been recognized as a high-risk disorder that leads to life-threatening diseases, such as coronary vascular disease. The aim of the present study was to investigate the association of fatty liver (FL) with MS in order to establish an effective treatment for FL. METHODS: One thousand two hundred and fifty-four individuals (694 males, 560 females) who visited the Department of General Medicine, International Medical Center of Japan for a human dry dock annual check-up from 2000 to 2004 were analyzed. RESULTS: FL was diagnosed in 41.5% of the males and 10.7% of the females, with the prevalence rate increasing in postmenopausal females over 55 years old. High body mass index and waist circumference were observed in those with FL, whereas body mass index reduction was strongly correlated with a decrease in alanine aminotransferase level (R = 0.6,P < 0.01). MS complications were more common in subjects with FL and the most common initial events of MS were shown to be obesity, hyperlipidemia and FL, followed by glucose intolerance and hypertension. Subjects with FL showed a higher level of high-sensitivity C-reactive protein (hs-CRP) (normal: FL = 0.38: 0.73 mg/L, P < 0.05), which was strongly correlated with serum markers that indicated lipid and glucose metabolism in females with FL (R = 0.61-0.77, P < 0.05). CONCLUSIONS: FL could be a part of or, at least, a predictor of MS. Further, bodyweight reduction is an effective treatment for FL.