Alteration of the leptin system appears to play a role in the inflammatory-metabolic response in catabolic diseases, such as chronic liver diseases.
Dr J. Ockenga and a team from Germany, the Netherlands and the UK, studied the association between leptin components, inflammatory markers and hepatic energy and substrate metabolism.
They investigated in vivo hepatic substrate and leptin metabolism in 40 patients, employing a combination of arterial and hepatic vein catheterization techniques and hepatic blood flow measurements.
|Bound leptin levels were elevated significantly in cirrhosis.|
| Alimentary Pharmacology & Therapeutics |
In addition to metabolic, inflammatory and neuroendocrine parameters, circulating levels of free leptin, bound leptin and soluble leptin receptor were determined.
Compared with controls, bound leptin and soluble leptin receptor levels were elevated significantly in cirrhosis, whilst free leptin did not increase.
In cirrhosis, bound leptin was correlated with soluble leptin receptor (r = 0.70, P < 0.001).
Free leptin was positively correlated with metabolic parameters such as energy storage (body fat mass; r = 0.36, P < 0.05), insulin and insulin resistance (r = 0.48; r = 0.46, P < 0.01), as well as with hepatic glucose and energy release (r = 0.35 and r = 0.40, P < 0.05).
In contrast, bound leptin and soluble leptin receptor were linked to proinflammatory cytokines and sympathetic activity (r = 0.61 and r = 0.56, P < 0.01).
Dr Ockenga concluded that, "The components of the leptin system (free leptin, bound leptin and soluble leptin receptor) have distinct roles in metabolic and inflammatory processes in patients with liver cirrhosis and the better understanding of this metabolic and inflammatory tissue-repair response may lead to innovative new therapeutic strategies in liver disease, as well as in various other catabolic diseases".