Changes in Plasma Ghrelin, Leptin, Insulin and Glucagon Like Peptide-1 Levels Are Correlated to Body Mass Index among Patients with Early Asymptomatic Non-Alcoholic Fatty Liver

Objectives: Saudi Arabia has high prevalence of obesity and Non-Alcoholic Fatty Liver (NAFL). Accurate diagnosis and dissection of early pathogenic events for fatty liver is important to furnish better grounds for early life-style intervention and therapy. We aimed to cross-sectionally assess the utility of ghrelin, leptin, insulin and glucagon-like peptide-1 (GLP-1) as early pathogenetic culprits for asymptomatic obesity-comorbid NAFL. Methods: Age- and gender-matching healthy lean controls with normal body mass index (BMI) [(Group A; n = 40) with BMI = 18.5-25], otherwise healthy asymptomatic overweight NAFL [(Group B; n = 64) with BMI = 25.1 30], and, otherwise healthy asymptomatic obese NAFL [(Group C; n = 76) with BMI > 30 - < 40] participants were enrolled. NAFL was transabdominally ultrasonographically characterized, and, non-alcoholic individuals with normal liver size and liver plasma enzymes were included. Fasting plasma levels of ghrelin, leptin, insulin and GLP-1 were quantitatively immunoassayed. Results: Ghrelin level was highest in Group A followed by Group C then Group B. Leptin was highest in Group A followed by Group B then Group C. Insulin was obviously elevated in Group C followed by Group B then Group A. GLP-1 negatively significantly related to BMI and was highest in group A followed by group B and then group C participants. Significant positive correlations were also observed between GLP-1 and leptin in all groups and between ghrelin and insulin in overweight NAFL participants. In overweight and obese NAFL individuals, ghrelin, leptin and GLP-1 were decreased whereas insulin was increased. Conclusion: Our results reflect the relative dysfunction and imbalanced equilibrium of the investigated hormones, and, suggest their early pathogenetic implication in asymptomatic NAFL in the targeted population.