Inverse relationship between circulating levels of leptin and bone mineral density in chronic liver disease.
OBJECTIVE
The pathophysiology of osteoporosis complicating chronic liver disease is unknown. Recent animal studies have found leptin to be a potent inhibitor of bone formation. The aim of this study was to investigate the relationship between serum leptin levels and bone mineral density in patients with chronic liver disease.


METHODS
Fifty-eight patients, 39 females and 19 males, and age- and gender-matched controls were included. Bone mineral density was measured by using dual energy X-ray absorptiometry. Serum leptin was measured by using a radioimmunoassay.


RESULTS
The mean serum leptin concentration was 10.4 +/- 11.3 and 15.2 +/- 17.9 ng/mL; P=0.11, in the patients and controls, respectively. Leptin correlated positively with body mass index in patients (r=0.40; P=0.003) and in controls (r=0.55; P < 0.0001). In patients classified as Child-Pugh grade B and C, serum leptin correlated negatively with bone mineral density in females at both the lumbar spine and the femoral neck (r=-0.78; P=0.04 and r=-0.86; P=0.03, respectively). In male patients, the correlation was only significant at the lumbar spine (r=-0.99; P=0.002 and r=-0.86; P=0.06, at the lumbar spine and femoral neck, respectively). No correlation was found between serum leptin and bone mineral density in the controls.


CONCLUSIONS
An inverse relationship between serum leptin and bone mineral density was found in patients with advanced chronic liver disease. The reasons for these findings are uncertain, but a pathophysiological role of circulating leptin in osteoporosis in chronic liver disease is possible.
Ormarsdóttir
S
S
Department of Internal Medicine, University Hospital, Uppsala, Sweden. sif.ormarsdottir@medsci.uu.se
Ljunggren
O
O
Mallmin
H
H
Olofsson
H
H
Blum
W F
WF
Lööf
L
L
D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood* / Q000209:etiology / Q000503:physiopathology
D020738:Leptin