Increased Soluble Leptin Receptor Levels in Morbidly Obese Patients With Insulin Resistance and Nonalcoholic Fatty Liver Disease |
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| Authors: | Valentina Medici MohamedR Ali Suk Seo Christopher A Aoki Lorenzo Rossaro Kyoungmi Kim Will D Fuller Tamas J Vidovszky William Smith Joy X Jiang Kalyani Maganti Peter J Havel Amit Kamboj Rajendra Ramsamooj Natalie J Török |
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| Institution: | 1. Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of California Davis Medical Center, Sacramento, California, USA;2. Department of Surgery, University of California Davis Medical Center, Sacramento, California, USA;3. Division of Biostatistics, Department of Public Health Sciences, University of California Davis, Davis, California, USA;4. Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA;5. Department of Nutrition, University of California Davis, Davis, California, USA;6. Department of Pathology, University of California Davis Medical Center, Sacramento, California, USA |
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| Abstract: | The adipocyte hormone, leptin has been demonstrated to have profibrogenic actions in vitro and in animal models. However, no correlation was found between plasma leptin levels and fibrosis stage in humans. Thus, our aim was to study whether soluble leptin receptor (SLR) or free leptin index (FLI; calculated as the ratio of leptin to SLR), may correlate better with the features of metabolic syndrome and with the histological grade and stage of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH). We studied a population (n = 104) of morbidly obese patients undergoing bariatric surgery. Data including BMI, type 2 diabetes mellitus, hypertension, and hyperlipidemia were obtained. Plasma fasting leptin and SLR, fasting glucose and insulin were measured, and homeostasis model of assessment insulin resistance (HOMAIR) index and FLI were calculated. All patients had intraoperative liver biopsies. Leptin levels correlated with the BMI. The multiple regression analysis indicated that increasing HOMA and decreasing FLI were predictors of steatosis in the liver (P < 0.0003). SLR levels were positively correlated with the presence of diabetes mellitus and the stage of fibrosis. In conclusion, increased SLR levels in morbidly obese patients with diabetes are correlated with the stage of liver fibrosis, and may reflect progressive liver disease. |
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