Elevated adiponectin is associated with poor outcome in children with biliary atresia

Background: Biliary atresia (BA) is a severe neonatal liver disease characterized by progressive fibrosclerotic obliteration of the extrahepatic biliary tree.

Objective: We compared serum adiponectin in post Kasai BA patients with healthy controls and associate adiponectin with clinical outcomes of BA patients.

Methods: One hundred and six postoperative BA patients and 40 controls were recruited in this study. BA patients were categorized into two groups based on their serum total bilirubin (TB) levels (TB<2 mg/dL, no jaundice vs. TB ≥2 mg/dL, persistent jaundice) and alanine aminotransferase (ALT) levels (ALT<45 IU/L, normal ALT vs. ALT ≥45 IU/L, elevated ALT). Serum adiponectin levels were determined by enzyme-linked immunosorbent assay.

Results: BA patients had higher serum adiponectin levels than healthy controls (172.8±90.9 vs. 93.9±53.5 ng/mL, p <0.001). Serum adiponectin levels were elevated in BA patients with jaundice compared to those without jaundice (229.6±89.0 vs. 139.7±74.5 ng/mL, p <0.001). Furthermore, BA patients with elevated ALT displayed significantly higher levels of serum adiponectin than those with normal ALT (187.2±91.8 vs. 117.6±62.8 ng/mL, p <0.001). Additionally, BA patients with portal hypertension had substantially higher serum adiponectin than those without portal hypertension and a poorer clinical outcome (207.0±90.2 vs. 118.5±62.1 ng/mL, p <0.001).

Conclusions: Increased serum adiponectin was associated with a poor outcome in postoperative BA patients. Serum adiponectin might be utilized as a biochemical indicator reflecting the deterioration of liver function and poorer outcome in BA after Kasai operation.