Increased soluble leptin receptor levels in morbidly obese patients with insulin resistance and nonalcoholic fatty liver disease.
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.
Medici
Valentina
V
Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of California Davis Medical Center, Sacramento, California, USA. valentina.medici@ucdmc.ucdavis.edu
Ali
Mohamed R
MR
Seo
Suk
S
Aoki
Christopher A
CA
Rossaro
Lorenzo
L
Kim
Kyoungmi
K
Fuller
Will D
WD
Vidovszky
Tamas J
TJ
Smith
William
W
Jiang
Joy X
JX
Maganti
Kalyani
K
Havel
Peter J
PJ
Kamboj
Amit
A
Ramsamooj
Rajendra
R
Török
Natalie J
NJ
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
D020738:Leptin; D054411:Receptors, Leptin
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