title: An assessment of serum leptin levels in patients with chronic viral hepatitis: a prospective study.
abstract: BACKGROUND
  The role of leptin in the course of liver disease due to chronic viral hepatitis (CVH) remains controversial. Our aims were to investigate the relationship between serum leptin concentrations and the severity of liver disease in a cohort of subjects with HBeAg negative chronic hepatitis B (CHB) and C (CHC) and to analyze the effect of body composition, the leptin system and insulin resistance together with viral factors on virologic response to antiviral treatment.
  
  
  METHODS
  We studied 50 (36 men) consecutive patients suffering from biopsy-proven CVH due to HBV (n = 25) or HCV (n = 25) infection. Thirty-two (17 men) healthy volunteers served as controls. Levels of serum leptin and insulin were determined by immunoassays at baseline and at the end of the treatment.
  
  
  RESULTS
  A significant association between serum leptin levels and the stage of hepatic fibrosis was noted; patients with cirrhosis presented higher serum leptin levels compared to those with lower fibrosis stage [CHB patients (17436 pg/ml vs 6028.5 pg/ml, p = 0.03), CHC patients (18014 pg/ml vs 4385 pg/ml, p = 0.05]. An inverse correlation between lower leptin levels and response to lamivudine monotherapy was noted in patients with CHB; those with a virologic response presented lower serum leptin levels (5334 vs 13111.5 pg/ml; p-value = 0.003) than non-responders. In genotype 1 CHC patients, insulin resistance played a significant role in the response to antiviral therapy.
  
  
  CONCLUSIONS
  Our data clearly suggest that cirrhosis due to CHB or CHC is associated with higher leptin levels. Increased serum leptin levels represent a negative prognostic factor for response to lamivudine monotherapy in patients with CHB. In CHC patients insulin resistance strongly influences the response to antiviral treatment in patients infected with genotype 1.
authors.affiliation: Department of Gastroenterology, Polyclinic General Hospital, Athens, Greece. spilios1@otenet.gr
authors.forename: Spilios
authors.initials: S
authors.lastname: Manolakopoulos
authors.forename: Sotirios
authors.initials: S
authors.lastname: Bethanis
authors.forename: Charis
authors.initials: C
authors.lastname: Liapi
authors.forename: Fotini
authors.initials: F
authors.lastname: Stripeli
authors.forename: Pantelis
authors.initials: P
authors.lastname: Sklavos
authors.forename: Alexandra
authors.initials: A
authors.lastname: Margeli
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Christidou
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Katsanika
authors.forename: Evangellos
authors.initials: E
authors.lastname: Vogiatzakis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tzourmakliotis
authors.forename: Stamatios
authors.initials: S
authors.lastname: Theocharis
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D001707:Biopsy, Needle; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D019259:Lamivudine / Q000008:administration & dosage; D020738:Leptin / Q000097:blood*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D011446:Prospective Studies; D011994:Recombinant Proteins; D012016:Reference Values; D012254:Ribavirin / Q000008:administration & dosage; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D020738:Leptin; D011994:Recombinant Proteins; D019259:Lamivudine; D012254:Ribavirin