Orexin-A Levels in Non-Alcoholic Fatty Liver Disease: A Case- Control Study Exploring Metabolic and Hepatic Correlations

Document Type : Original Article

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Department of Internal Medicine, Ain Shams University

10.21608/asmj.2025.358987.1385

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is a global health concern, closely associated with obesity, type 2
diabetes mellitus (T2DM) and dyslipidemia. Orexin-A, a neuropeptide involved in metabolic regulation, has been implicated
in NAFLD pathophysiology.
Aim of the work: To assess peripheral Orexin-A levels in NAFLD patients and their correlation with metabolic risk factors.
Patients and Methods: This case-control study included 45 participants: 15 NAFLD patients without diabetes (Group 1), 15
NAFLD patients with diabetes (Group 2), and 15 healthy controls (Group 3). Lipid profile, HbA1c, and NAFLD fibrosis score
(NFS) were analyzed. A Sandwich ELISA assay was employed to determine serum Orexin-A levels.
Results: NAFLD patients exhibited significantly lower Orexin-A levels compared to controls (0.34 vs. 2.12 pg/mL, P <
0.001). Orexin-A correlated negatively with serum albumin (r = -0.361, P = 0.05) and blood urea in diabetic NAFLD patients
(r = -0.612, P = 0.015). ROC analysis demonstrated that Orexin-A ≤0.66 pg/mL effectively differentiated NAFLD patients
from controls (AUC = 0.877, sensitivity = 90%, specificity = 86.67%).
Conclusion: Orexin-A is significantly reduced in NAFLD patients, suggesting its potential role as a biomarker for NAFLD
detection and disease severity assessment.

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