Serum leptin levels in post-hepatitis liver cirrhosis.
OBJECTIVE
Little information is available on the involvement of leptin in clinical conditions associated with malnutrition, such as liver cirrhosis. The behaviour of serum leptin in patients with different Child-Pugh score, post-hepatitis liver cirrhosis and insulin sensitivity has therefore been investigated and compared with that in alcoholic Child C patients.


METHODS
Sixty-four patients, aged 51 to 62 years, with different degrees of post-hepatitis cirrhosis or Child C alcoholic cirrhosis were compared with 15 age-matched control subjects. Body composition was estimated by skinfold thickness. Serum leptin, glucose and insulin were assayed.


RESULTS
In post-hepatitis patients a significant reduction in leptin levels was observed as the Child-Pugh score worsened (men: 2.94+/-1.61 in Child C vs 6.78+/-2.49 ng/ml in controls, p<0.001; women: 4.14+/-0.66 in Child C vs 16.16+/-3.90 ng/ml in controls, p<0.02). Conversely, only the men with alcoholic liver cirrhosis showed a significant difference in leptin concentration compared to controls (8.5+/-2.1 vs 16.4+/-7.9 kg, p<0.05). In particular, Child C, alcoholic cirrhotic women had a significantly (p=0.03) higher level of leptin than post-hepatitis matched women. A positive correlation was observed between leptin and fat mass (men R2=0.59, p<0.0001 and women R2=0.65, p<0.0001). While fasting levels of serum leptin correlated significantly with insulin concentrations in controls, a similar relationship was not observed in the cirrhotic population, which displayed higher insulin concentrations than controls.


CONCLUSIONS
In contrast to findings in alcoholic cirrhotic women, low leptin values in post-hepatitis cirrhotic patients mainly represent the expression of a reduced fat mass.
Greco
A V
AV
Istituto di Medicina Interna e Geriatria, Catholic University, Rome, Italy. agreco@rm.unicatt.it
Mingrone
G
G
Favuzzi
A
A
Capristo
E
E
Gniuli
D
D
Addolorato
G
G
Brunani
A
A
Cavagnin
F
F
Gasbarrini
G
G
D000273:Adipose Tissue / Q000473:pathology; D005215:Fasting / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology / Q000503:physiopathology / Q000821:virology*; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012016:Reference Values
D020738:Leptin