Serum leptin concentrations in liver cirrhosis: relationship to the severity of liver dysfunction and their characteristic diurnal profiles.

Liver cirrhosis is often associated with malnutrition status, and while leptin, which reduces food intake, appears to contribute to it, there have been few detailed studies of serum leptin concentrations in cases of liver cirrhosis. We therefore measured serum leptin concentrations in liver cirrhosis and investigated its relationship with gender, body composition analysis, and the severity of liver dysfunction and the patterns of diurnal profiles in serum leptin. There were no significant differences between the serum leptin concentrations in the healthy controls and patients with liver cirrhosis. The serum leptin concentrations in liver cirrhosis cases were significantly higher in females than in males. Significant positive correlations were observed between the serum leptin and the body composition analysis data such as body mass index (BMI), arm circumference (AC), and triceps skin fold thickness (TSF). There was no correlations between BMI and arm muscle circumference (AMC). No changes in leptin levels were observed in association with the progression of liver dysfunction, according to the Child-Pugh classification. The diurnal profiles showed different patterns in liver cirrhosis and diabetes mellitus. In diabetes, a nocturnal rise was seen beginning around 21:00, but in liver cirrhosis, the rise in serum leptin started around 12:00, peaked at 13:00, and remained elevated until 03:00 in the morning. No associations were observed between the variations in serum leptin concentrations and variations in blood glucose or plasma insulin levels. In summary, serum leptin concentrations in liver cirrhosis are higher in women, positively correlated with the body composition analysis data, but not correlated with the severity of liver dysfunction. The diurnal profiles in serum leptin concentrations in liver cirrhosis also showed a different pattern from the profiles in diabetes with the values starting to increase earlier, during the daytime. Further study regarding the relation of leptin to nutrition and metabolic abnormalities in liver cirrhosis appears to be necessary.