title: Increased soluble leptin receptor levels in morbidly obese patients with insulin resistance and nonalcoholic fatty liver disease.
abstract: The adipocyte hormone, leptin has been demonstrated to have profibrogenic actions in vitro and in animal models. However, no correlation was found between plasma leptin levels and fibrosis stage in humans. Thus, our aim was to study whether soluble leptin receptor (SLR) or free leptin index (FLI; calculated as the ratio of leptin to SLR), may correlate better with the features of metabolic syndrome and with the histological grade and stage of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH). We studied a population (n = 104) of morbidly obese patients undergoing bariatric surgery. Data including BMI, type 2 diabetes mellitus, hypertension, and hyperlipidemia were obtained. Plasma fasting leptin and SLR, fasting glucose and insulin were measured, and homeostasis model of assessment insulin resistance (HOMA(IR)) index and FLI were calculated. All patients had intraoperative liver biopsies. Leptin levels correlated with the BMI. The multiple regression analysis indicated that increasing HOMA and decreasing FLI were predictors of steatosis in the liver (P < 0.0003). SLR levels were positively correlated with the presence of diabetes mellitus and the stage of fibrosis. In conclusion, increased SLR levels in morbidly obese patients with diabetes are correlated with the stage of liver fibrosis, and may reflect progressive liver disease.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of California Davis Medical Center, Sacramento, California, USA. valentina.medici@ucdmc.ucdavis.edu
authors.forename: Valentina
authors.initials: V
authors.lastname: Medici
authors.forename: Mohamed R
authors.initials: MR
authors.lastname: Ali
authors.forename: Suk
authors.initials: S
authors.lastname: Seo
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Aoki
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rossaro
authors.forename: Kyoungmi
authors.initials: K
authors.lastname: Kim
authors.forename: Will D
authors.initials: WD
authors.lastname: Fuller
authors.forename: Tamas J
authors.initials: TJ
authors.lastname: Vidovszky
authors.forename: William
authors.initials: W
authors.lastname: Smith
authors.forename: Joy X
authors.initials: JX
authors.lastname: Jiang
authors.forename: Kalyani
authors.initials: K
authors.lastname: Maganti
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Havel
authors.forename: Amit
authors.initials: A
authors.lastname: Kamboj
authors.forename: Rajendra
authors.initials: R
authors.lastname: Ramsamooj
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Török
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000097:blood*; D018450:Disease Progression; D005234:Fatty Liver / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D020738:Leptin / Q000097:blood*; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D054411:Receptors, Leptin / Q000097:blood*; D012044:Regression Analysis
chemical_list: D020738:Leptin; D054411:Receptors, Leptin
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