Serum leptin level in nonalcoholic steatohepatitis

ABSTRACT

Nonalcoholic steatohepatitis [NASH] has increasingly been recognized as a common form of chronic liver disease over the past 20 years. Activated stellate cells have been shown to produce leptin and studies of leptin in NASH are lacking. The aim of this work was to assess the correlation between the serum leptin level and the degree of the histopathological changes of the liver in patients with NASH. Thirty patients with NASH and ten healthy controls were studied to identify the serum leptin level in such patients and compare its level with the histopathologic changes of liver biopsy. All patients were negative for HBsAg, AntiHCV antibodies, circulating autoantibodies and negative history of alcohol use. 90% were females, 83.3% were obese [BMI >30 kg/m2], 43.3% were diabetics, 43.3% had hypercholesterolemia and 63.3% had high triglycerides level. 3.3% had elevated AST, 6.7% had elevated ALT and 53.3% had AST/ALT ratio >1. Histopathologically, all patients had steatosis, ballooning of hepatocytes and lobular inflammation, 86.7% had portal inflammation, 93.3% had perisinusoidal fibrosis, 90% had periportal fibrosis, 16.7% had bridging fibrosis and 3.3% had cirrhosis. The serum leptin level was higher in the patient group [33 +/- 24.63 ng/ml] compared with the control group [12.9 +/- 10.01 ng/ml]. Leptin level was higher in females diabetics and obese hyperlipidemic patients. There was an increase in the level of serum leptin with the increased severity of the pathologic grade of NASH. Also, there was an insignificant relation between the leptin level and the pathologic stage of fibrosis in NASH. The study suggested that there was no significant relation between serum leptin level and the grade of necroinflammation or the stage of fibrosis in patients with NASH