Serum leptin and homeostasis model assessment-IR as novel predictors of early liver fibrosis in chronic hepatitis B virus infection

Br J Biomed Sci. 2018 Oct;75(4):192-196. doi: 10.1080/09674845.2018.1505187. Epub 2018 Sep 7.

Abstract

Background: The relationship between hepatitis B virus (HBV) infection, leptin and insulin resistance remains unclear. We hypothesised links between serum leptin and insulin resistance in non-diabetic patients with chronic viral hepatitis B infection and their relation to liver fibrosis.

Methods: We recruited 190 untreated patients with chronic HBV infection and 72 healthy controls. Serum leptin, fasting glucose, insulin, liver function tests (LFTs), C-peptide and Homeostasis model assessment-IR (HOMA-IR) were measured/calculated by ELISA and standard techniques.

Results: Serum leptin, C-peptide (both P < 0.001), HOMA-IR (P = 0.021) and several LFTs were increased in patients with chronic HBV-infection. In multivariate regression analysis, both HOMA-IR (P = 0.003) and leptin (P = 0.002) were significant independent predictors of HBV infection. There were significant positive correlations (P < 0.01) between leptin and HOMA-IR (r = 0.81), between serum leptin and METAVIR activity (r = 0.95), and between HOMA-IR and BMI (r = 0.75), fasting glucose (r = 0.005), and fasting insulin (r = 0.81). Several LFTs, glucose and insulin correlated modestly (r = 0.61-0.69, P < 0.05) with leptin.

Conclusion: Serum leptin may be related to the rate of fibrosis progression in nondiabetic patients with chronic HBV infection. Follow-up by serial measurement of serum leptin and HOMA-IR in non diabetic HBV-infected patients may be used as a non-invasive marker of early liver fibrosis.

Keywords: Leptin; hepatitis B virus; homeostasis model assessment–IR; liver fibrosis.

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Blood Glucose / genetics
  • C-Peptide / blood
  • Fasting
  • Female
  • Hepatitis B virus / pathogenicity
  • Hepatitis B, Chronic / blood*
  • Hepatitis B, Chronic / genetics
  • Hepatitis B, Chronic / pathology
  • Hepatitis B, Chronic / virology
  • Homeostasis / genetics
  • Humans
  • Insulin / blood
  • Insulin Resistance / genetics
  • Leptin / blood*
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / virology
  • Liver Function Tests
  • Male
  • Middle Aged

Substances

  • Biomarkers
  • Blood Glucose
  • C-Peptide
  • Insulin
  • Leptin