Alterations in serum leptin in liver diseases

Ben‐Ari, Ziv; Kaspa, Ran Tur; Fainaru, M

doi:10.1016/s0168-8278(00)80815-6

Cited by 12 publications

(14 citation statements)

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“…Baseline leptin in cirrhotics was found to be elevated as previously reported [112][113][114][115][116] and leptin effects on energy intake and resting energy expenditure were disturbed in these patients. Leptin has been shown to increase REE [103] but in a recent study performed in non-cirrhotic individuals total and free leptin were reported to be negatively and bound leptin positively associated with REE [104].…”

Section: Metabolic Disturbances In Liver Cirrhosis (Iii)supporting

confidence: 78%

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Intestinal permeability in cirrhotic patients with and without ascites

Kalaitzakis

Johansson

Bjarnason³

et al. 2006

Scandinavian Journal of Gastroenterology

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Malnutrition is a common finding in patients with liver cirrhosis. Malnutrition has been shown to be associated with increased morbidity and mortality. Its pathogenesis remains unclear but both poor dietary intake and increased energy expenditure have been reported.Spontaneous bacterial peritonitis is an important clinical problem in cirrhotics. It may occur as a consequence of repeated access of bacteria from the intestinal lumen (translocation) to the mesenteric lymph nodes. One of the mechanisms proposed to explain bacterial translocation in cirrhosis includes increased intestinal permeability.The aims of the present study were to evaluate GI symptoms in cirrhotic patients and their possible relation to nutritional status, to assess whether gastric sensorimotor dysfunction or metabolic disturbances are associated with reduced food intake, and to investigate the role of ascites in intestinal permeability in patients with liver cirrhosis.Gastrointestinal symptoms and health-related quality of life (HRQOL) were assessed with the aid of two questionnaires. Gastric sensorimotor function was measured by means of an electronic barostat. Food intake, as assessed with a food diary, was related to fasting and postprandial glucose, insulin, leptin, and ghrelin concentrations. Intestinal permeability was evaluated by a 51 Cr-EDTA permeability test. Cirrhotics were found to have increased severity of GI symptoms compared with reference values from the general population. A relationship between GI symptoms and compromised HRQOL as well as weight loss was observed.Proximal stomach relaxation to a meal was increased in patients with liver cirrhosis as compared with healthy controls but the relation between gastric accommodation and energy intake was found to be disturbed in these patients. Gastric sensitivity to distension was shown to be related to GI symptom severity and to liver cirrhosis severity scores.Patients with liver cirrhosis exhibited higher postprandial insulin and glucose concentrations compared to controls. Cirrhotics had higher fasting leptin that fell significantly postmeal and they showed an attenuated increase of ghrelin before the next expected meal. Altered glucose and hormonal levels in patients with cirrhosis were associated with poor food intake.Only a few patients with cirrhosis had increased intestinal permeability, as assessed by a 51 Cr-EDTA test, which was not influenced to a major extent by ascites. Conclusions: In patients with liver cirrhosis GI symptom severity is high and it is associated with impaired HRQOL and weight loss. Gastric accommodation is not involved in the poor food intake observed in cirrhotics and gastric sensitivity seems to be a relevant factor for GI symptom generation in these patients. Altered postprandial glucose, leptin, and ghrelin levels are correlated to reduced energy intake in this patient group. Increased intestinal permeability is probably of limited importance in the pathophysiology of bacterial infections in patients with liver cirrhosis and ascites.

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Section: Metabolic Disturbances In Liver Cirrhosis (Iii)supporting

confidence: 78%

“…Leptin levels have been found to be high in patients with alcoholic [112,113] and with post-hepatitic [113][114][115] cirrhosis and to be positively correlated to insulin levels [113]. However, only few studies are available on the relations of leptin to energy intake and REE in these patients [25,116].…”

Section: Leptinmentioning

confidence: 99%

Intestinal permeability in cirrhotic patients with and without ascites

Kalaitzakis

Johansson

Bjarnason³

et al. 2006

Scandinavian Journal of Gastroenterology

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“…For example, many studies have shown elevated leptin levels in patients with alcoholic and infectious liver disease (Henriksen et al 1999, Greco et al 2000, Campillo et al 2001, Nicolas et al 2001. Recently, Nakamuta et al (2001) demonstrated normal leptin levels in patients with nonalcoholic liver disease; Ben-Ari et al (2002) found low leptin levels in patients with primary biliary cirrhosis. Both leptin and iron load have been implicated in the pathogenesis of human liver fibrosis (Pietrangelo 1998, Casaril et al 2000, Ikejima et al 2001, and iron overload has been associated with steatohepatitis and insulin resistance (Mendler et al 1999, Moirand et al 2000.…”

Section: Where Might the Assessment Of The Leptin Status With Percentmentioning

confidence: 99%

Definition and characterization of relative hypo- and hyperleptinemia in a large Caucasian population

Buettner

Bollheimer²,

Zietz³

et al. 2002

Journal of Endocrinology

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The adipocyte-derived hormone, leptin, has been implicated in the regulation of appetite, weight gain and glucose homeostasis as well as in liver fibrogenesis, hematopoiesis and immune function. No previous reports have clearly defined pathologically elevated or decreased serum leptin levels for Caucasian adults. The aim of this study was to define and characterize subjects with relative hyper-and hypoleptinemia in a large population-based German cohort.Percentiles of leptin levels by body mass index (BMI) were calculated from 4971 adult Germans, and the participants with leptin levels above the 95th and below the 5th percentile were defined as relatively hyperleptinemic and relatively hypoleptinemic, respectively, for their BMI.These participants were compared with the intermediate group with respect to anthropometric and clinical data and parameters of glucose and iron metabolism, lipid status, renal, adrenal and reproductive function.Relatively hyperleptinemic participants (HL) showed higher insulin, c-peptide, and total cholesterol levels than the hypoleptinemic subjects; in males, ferritin levels were higher and testosterone levels lower in the HL group.In conclusion, we report the first percentile curves for serum leptin by BMI in a large Caucasian population. Relatively low leptin values may be associated with a lower metabolic risk than relatively high serum leptin values.

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“…Bazı çalışmalarda KHB'li hastalarda serum leptin düzeyleri karaciğer fibrozisi arasında anlamlı bir ilişki bulunamamıştır. 23,24 Bazılarında ise KHB'li hastalarda karaciğerde fibrozis varlığında serum leptin düzeyi sağlıklı kontrol grubuna göre artmış bulunmuştur. 25 Bizim çalışmamızda KHB'li hastalarda serum leptin düzeyleri kontrol grubundan farklı bulunmamıştır.…”

Section: Discussionunclassified