Child-Pugh classification dependent alterations in serum leptin levels among cirrhotic patients: a case controlled study.

Fusun F Bolukbas,Ali Yayla,Mehmet Horoz,Cengiz Bolukbas,Mahmut Gumus,Fadile Zeyrek,Oya Ovunc,Mehmet Erdogan

doi:10.1186/1471-230x-4-23

Abstract

BackgroundAs anorexia and hypermetabolism are common in cirrhosis, leptin levels may be increased in this disease. In this study, we investigated the relation between the severity of disease and serum leptin levels in post-hepatitis cirrhosis and the role of body composition, gender and viral aetiology of cirrhosis in this association.MethodsThirty-five cases with post-hepatitis cirrhosis and 15 healthy controls were enrolled in this study. Body composition including body mass index, body fat percentage and body fat mass were determined. Serum leptin levels were assayed.ResultsLeptin levels were significantly higher among cirrhotic patients independent of sex compared to controls (p = 0.001). Female patients in both groups have had higher leptin levels than males (in cirrhotics p = 0.029, in controls p = 0.02).Cirrhotic patients in each of A, B and C subgroups according to the Child- Pugh classification revealed significantly different levels compared to controls (p = 0.046, p = 0.004, p = 0.0001, respectively). Male cirrhotics in Child-Pugh Class B and C subgroups had significantly higher leptin levels compared to male controls (p = 0.006, p = 0.008). On the other hand, female patients only in Child Pugh class C subgroup have had higher levels of serum leptin compared to controls (p = 0.022).Child-Pugh classification has been found to be the sole discriminator in determination of leptin levels in cirrhotics by linear regression (beta: 0.435 p = 0.015).ConclusionSerum leptin levels increase in advanced liver disease independently of gender, body composition in posthepatitic cirrhosis. The increase is more abundant among patients that belong to C subgroup according to the Child- Pugh classification.

Highlights

As anorexia and hypermetabolism are common in cirrhosis, leptin levels may be increased in this disease
The increase is more abundant among patients that belong to C subgroup according to the Child- Pugh classification
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Summary

Introduction

As anorexia and hypermetabolism are common in cirrhosis, leptin levels may be increased in this disease. We investigated the relation between the severity of disease and serum leptin levels in post-hepatitis cirrhosis and the role of body composition, gender and viral aetiology of cirrhosis in this association. A 16-kilodalton protein, is involved in the regulation of food intake and body composition [1] It was discovered in 1994 by Friedman et al [2] and has been proposed to physiologically regulate body weight by suppressing appetite and increasing energy expenditure [1,3,4]. Nutritional status of cirrhotic cases represents a wide range in normal to severe malnutrition, connected with severity of the disease [8] It appears that relationship of serum leptin levels and nutritional status in post-hepatitis cirrhosis has not been fully clarified yet

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Conclusion