Leptin, osteocalcin, and bone mineral density in post-hepatitic liver cirrhosis

The pathophysiology of osteoporosis complicating chronic liver disease is unknown. Some studies have found leptin to be a potent inhibitor of bone formation. The aim of this study is to investigate the relationship between leptin, osteocalcin and bone mineral density [BMD] in liver cirrhosis. Sixty patients with post-hepatitic liver cirrhosis were classified into three groups: group I, 20 pre-menopausal females; group II, 20 post-menopausal females; and group III, 20 males. In addition, 21 age- and sex-matched healthy subjects [seven for each group] were included as control subjects. Patients were classified according to Child-Pugh classification into grade A [n = 0], grade B [n = 38] and grade C [n = 22]. Serum osteocalcin, leptin and parathyroid hormone [PTH], in addition to liver functions test, hepatitis B surface antigen [HBsAg], anti-hepatitis C virus [HCV], serum phosphorus and calcium were measured. Bone mineral density [BMD] was measured by calcaneal ultrasound. Leptin was elevated in all groups [I, II and III] when compared with their control groups [p < 0.01, p < 0.001 and p < 0.01, respectively]. Further, it was high in female groups [I and II] compared to males [group III], [p < 0.01 each]. BMD and serum osteocalcin decreased in each group compared with the respective control [p < 0.001; p < 0.01 in group I, p < 0.05; p < 0.001 in group II and p < 0.001; p < 0.001 in group III, respectively]. In the Child-Pugh grade C group, BMD and osteocalcin were low [p < 0.001, p < 0.05, respectively], while serum leptin was elevated [p < 0.05], when compared with grade B group. Leptin correlated negatively with serum osteocalcin [r = -0.553; p < 0.001], BMD [r = -0.229; p < 0.05], albumin [r = -0.449; p < 0.001] and albumin/globulin [A/G] ratio [r = -0.661; p < 0.001], while positively correlated with both aspartate transaminase [AST] [r = 0.462; p < 0.001], and alanine transaminase [ALT] [r = 0.483; p < 0.001]. Osteocalcin negatively correlated with intact iPTH [r = -0.370, p < 0.001], while positively correlated with BMD [r = 0.418; p < 0.001], albumin [r = 0.659; p < 0.001] and A/G ratio [r = 0.444; p < 0.001]. Serum leptin was elevated in cirrhotic patients and may have a role in the pathogenesis of osteoporosis in liver cirrhosis

Soluble interleukin-2 receptor [sIL-2R], tumor necrosis factor alpha [TNF - alpha] and its receptor as prognostic markers in non-hodgkin's lymphoma

This study aimed at assessing whether pretreatment levels of interleukin-6 [IL-6], interleukin-10 [IL-10], tumor necrosis factor-alpha [TNF- alpha], soluble TNF type 1 receptor [p55-R-TNF] and soluble interleukin-2 receptor [sIL-2R] are related to known clinical and biological prognostic factors of lymphoma. Thirty-five patients diagnosed to have non-Hodgkin's lymphoma [NHL] were studied. Patients were treated by 6 cycles of multiagent chemotherapy regimen containing Cyclophosphamide, Adriamycin, Vincristine and Prednisolone [CHOP]. Serum cytokines levels were determined in their serum by an Enzyme Amplified Sensitivity Immunoassay [EASIA] and chemiluminescent enzyme immunometric assay. Statistically significant higher pretreatment levels of sIL-2R [p<0.0001], IL-6 [P<0.0001], IL-10 [p=0.01] and p55-R-TNF [P<0.0001] were observed in NHL patients as compared to controls. sIL- 2R and TNF- alpha levels correlated with tumor burden [P> 0.02 and> 0.01, respectively], while, significantly high levels of IL-6, TNF- alpha and p55-R-TNF were found in patients presented with beta symptoms [P = 0.01, 0.05 and 0.025 respectively]. Following treatment, cytokine levels progressively declined in responding patients. However, no single parameter was found to be of independent prognostic significance. Dramatic variations in sIL- 2 R and TNF- alpha levels between responder and non-responders suggested that combination of these markers might have a prognostic value in management of NHL. These markers could be used in monitoring disease activity and identification of high risk patients who need more aggressive therapy