title: Serum Leptin Is a Biomarker of Malnutrition in Decompensated Cirrhosis.
abstract: OBJECTIVE
  Malnutrition is a leading cause of morbidity and mortality in cirrhosis. There is no consensus as to the optimal approach for identifying malnutrition in end-stage liver disease. The aim of this study was to measure biochemical, serologic, hormonal, radiographic, and anthropometric features in a cohort of hospitalized cirrhotic patients to characterize biomarkers for identification of malnutrition.
  
  
  METHODS
  In this prospective observational cohort study, 52 hospitalized cirrhotic patients were classified as malnourished (42.3%) or nourished (57.7%) based on mid-arm muscle circumference < 23 cm and dominant handgrip strength < 30 kg. Anthropometric measurements were obtained. Appetite was assessed using the Simplified Nutrition Appetite Questionnaire (SNAQ) score. Fasting levels of serum adipokines, cytokines, and hormones were determined using Luminex assays. Logistic regression analysis was used to determine features independently associated with malnutrition.
  
  
  RESULTS
  Subjects with and without malnutrition differed in several key features of metabolic phenotype including wet and dry BMI, skeletal muscle index, visceral fat index and HOMA-IR. Serum leptin levels were lower and INR was higher in malnourished subjects. Serum leptin was significantly correlated with HOMA-IR, wet and dry BMI, mid-arm muscle circumference, skeletal muscle index, and visceral fat index. Logistic regression analysis revealed that INR and log-transformed leptin were independently associated with malnutrition.
  
  
  CONCLUSIONS
  Low serum leptin and elevated INR are associated with malnutrition in hospitalized patients with end-stage liver disease.
authors: Department of Medicine, Divisions of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh PA 15213, United States of America.
authors: Vikrant
authors: V
authors: Rachakonda
authors: Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America.
authors: Amir A
authors: AA
authors: Borhani
authors: Department of Medicine, Divisions of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh PA 15213, United States of America.
authors: Michael A
authors: MA
authors: Dunn
authors: Department of Medicine, Divisions of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh PA 15213, United States of America.
authors: Margaret
authors: M
authors: Andrzejewski
authors: Department of Medicine, Divisions of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh PA 15213, United States of America.
authors: Kelly
authors: K
authors: Martin
authors: Department of Medicine, Divisions of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh PA 15213, United States of America.
authors: Jaideep
authors: J
authors: Behari
mesh_terms: D054392:Adipokines / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D016207:Cytokines / Q000097:blood; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D019934:International Normalized Ratio; D020738:Leptin / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D054392:Adipokines; D015415:Biomarkers; D016207:Cytokines; D006728:Hormones; D020738:Leptin