Circulating vaspin and its relationship with insulin sensitivity, adiponectin and liver histology in subjects with non-alcoholic steatohepatitis

摘要

We read with great interest the recent paper by Gene et al. [1]. They had compared serum vaspin levels in 50 patients with nonalcoholic steatohepatitis (NASH) and 30 age- and sex-matched controls with no evidence of liver disease. The results from uni-variate analysis indicated that serum vaspin levels were higher in patients with NASH than in controls. However, circulating vaspin levels did not differ significantly between patients and controls after adjusting for glucose, lipid parameters and measures of insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR). The study design used by the authors - focusing on NASH only and not the entire spectrum beginning with simple stea-tosis, progressing through borderline NASH and ending with definite NASH - offers numerous advantages, including a good internal validity due to the use of a small, homogeneous sample. However, the study also suffers from key statistical issues that need to be addressed to ensure that the result is valid. Specifically, the authors conducted covariate-adjusted analyses which aimed to refine the analysis of the overall difference in serum vaspin levels by taking account of the fact that some baseline characteristics may be related to vaspin levels and may be unbalanced between patients and controls.