GENDER-DEPENDENT ALTERATIONS IN SERUM LEPTIN IN ALCOHOLIC CIRRHOSIS

Background & Aims: Leptin is a peptide that decreases food intake and increases energy expenditure, It is produced in fat cells, is stimulat ed by cytokines, and its levels in serum are higher in females. Becaus e anorexia, hypermetabolism, and elevated cytokine levels are frequent ly observed in cirrhosis, we hypothesized that the serum leptin level would be elevated in cirrhosis, The aim of this study was to investiga te the relationship of serum leptin to gender, body composition, and t umor necrosis factor (TNF). Methods: Male (n = 18) and female (n = 10) abstinent alcoholic cirrhotic patients were studied and compared with control subjects (15 male and 8 female), Fat mass, fat-free body mass , and body cell mass were calculated by using H-2[O-18] and bromide di lution methodology, Serum leptin and TNF concentrations were measured by immunoassays. Results: Fat mass was decreased only in male cirrhoti cs (P < 0.05), whereas body cell mass was decreased in both male and f emale cirrhotics (P < 0.01). Leptin levels were elevated in female (P < 0.001) but not male cirrhotics compared with controls, When expresse d per kilogram of fat mass, leptin was elevated in both male (P < 0.01 ) and female (P < 0.01) cirrhotics. Women in both cirrhotic and contro l groups had higher leptin levels than men. TNF was elevated in both m ale and female cirrhotics and did not correlate with leptin levels, Co nclusions: Cirrhotics have elevated serum leptin levels: which are rel ated to both gender- and gender-dependent alterations in body composit ion.