Serum leptin levels in post-hepatitis liver cirrhosis

Background/Aims: Little information is available on the involvement of lept in in clinical conditions associated with malnutrition, such as liver cirrh osis. The behaviour of serum leptin in patients with different Child-Pugh s core, post-hepatitis liver cirrhosis and insulin sensitivity has therefore been investigated and compared with that in alcoholic Child C patients. Methods: Sixty-four patients, aged 51 to 62 years, with different degrees o f post-hepatitis cirrhosis or Child C alcoholic cirrhosis were compared wit h 15 age-matched control subjects. Body composition was estimated by skinfo ld thickness. Serum leptin, glucose and insulin were assayed. Results: In post-hepatitis patients a significant reduction in leptin level s was observed as the Child-Pugh score worsened (men: 2.94+/-1.61 in Child C vs 6.78+/-2.49 ng/ml in controls, p<0.001; women: 4.14+/-0.66 in Child C vs 16.16+/-3.90 ng/ml in controls, p<0.02). Conversely, only the men with a lcoholic liver cirrhosis showed a significant difference in leptin concentr ation compared to controls (8.5+/-2.1 vs 16.4+/-7.9 kg, p<0.05). In particu lar, Child C, alcoholic cirrhotic women had a significantly (p=0.03) higher level of leptin than post-hepatitis matched women. A positive correlation was observed between leptin and fat mass (men R-2=0.59, p<0.0001 and women R-2=0.65, p<0.0001). While fasting levels of serum leptin correlated signif icantly with insulin concentrations in controls, a similar relationship was not observed in the cirrhotic population, which displayed higher insulin c oncentrations than controls. Conclusions: In contrast to findings in alcoholic cirrhotic women, low lept in values in post-hepatitis cirrhotic patients mainly represent the express ion of a reduced fat mass.