An assessment of serum leptin levels in patients with chronic viral hepatitis

[Guest guest]

Research article

An assessment of serum leptin levels in patients with chronic viral

hepatitis: a prospective study

Spilios Manolakopoulos1 , Sotirios Bethanis1 , Charis Liapi2 , Fotini

Stripeli1 , Pantelis Sklavos1 , andra Margeli3 , Aggeliki Christidou1

, Aggeliki Katsanika1 , Evangellos Vogiatzakis4 , Dimitrios

Tzourmakliotis1 and Stamatios Theocharis3

1Department of Gastroenterology, Polyclinic General Hospital, Athens, Greece

2Department of Pharmacology, University of Athens, School of Medicine,

Athens, Greece

3Department of Forensic Medicine and Toxicology, University of Athens,

School of Medicine, Athens, Greece

4Department of Microbiology, Polyclinic General Hospital, Athens, Greece

BMC Gastroenterology 2007, 7:17 doi:10.1186/1471-230X-7-17

The electronic version of this article is the complete one and can be found

online at: http://www.biomedcentral.com/1471-230X/7/17

Received 9 January 2007

Accepted 31 May 2007

Published 31 May 2007

© 2007 Manolakopoulos et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative

Commons Attribution License (http://creativecommons.org/licenses/by/2.0),

which permits unrestricted use, distribution, and reproduction in any

medium, provided the original work is properly cited.

--------------------------------------------------------------------------------

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.

Conclusion

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.

_________________________________________________________________

Get a preview of Live Earth, the hottest event this summer - only on MSN

http://liveearth.msn.com?source=msntaglineliveearthhm