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At least 415 records · Page 23Linked to original sources
PubMed2001

Plasma and liver carnitine status of children with chronic liver disease and cirrhosis.

BACKGROUND: Carnitine is an essential cofactor in the transfer of long-chain fatty acids across the inner mitochondrial membrane for oxidation. As its synthesis is performed in the liver, alterations in carnitine metabolism is expected in liver diseases, especially in cirrhosis. METHODS: In this study, we investigated plasma and liver carnitine concentrations of 68 children with chronic liver disease, 36 of whom had cirrhosis as well. Carnitine level was determined by enzymatic method. RESULTS: Plasma and liver carnitine concentrations were not correlated. Mean plasma carnitine level of cirrhotic children was significantly lower than that of the control group (P<0. 0001). While there was no difference between liver carnitine concentrations of children with chronic liver disease and cirrhosis (P>0.05), mean plasma level of cirrhotics were lower (P<0.05). Plasma carnitine was correlated with albumin, triglyceride and gamma glutamyl transpeptidase (GGT) in patients with chronic liver disease (P<0.05). Liver carnitine was correlated with GGT in cirrhotic patients (P<0.005). Children with malnutrition had higher plasma and liver carnitine levels (P<0.05). The highest plasma and liver carnitine levels were detected in children with biliary atresia and criptogenic cirrhosis, respectively. Both the lowest plasma and liver carnitine levels were detected in Wilson's disease. CONCLUSION: Children with cirrhosis have low plasma carnitine concentrations. This finding is prominent in children with Wilson's disease. As carnitine is an essential factor in lipid metabolism, the carnitine supplementation for patients with cirrhosis in childhood, especially with Wilson's disease, seems to be mandatory.

Adolescent↗
PubMed2003

Isolation of human hepatocytes from livers rejected for liver transplantation on a national basis: results of a 2-year experience.

The offer of liver transplantation to many patients affected by liver failure is limited by organ shortage. Clinical application of human-based liver cell therapies, such as bioartificial liver and hepatocyte transplantation, might support liver transplantation, allowing more patients to be treated and decreasing mortality in the waiting list. The development of a standardized method of hepatocyte isolation is a mainstay for large-scale application of liver cell therapy. The aim of this study is to analyze retrospectively a 2-year experience of human hepatocyte isolation from livers rejected from transplantation at organ harvesting, performed on a national basis in Italy. All the livers judged unsuitable for transplantation were considered for hepatocyte isolation. Macrosteatosis greater than 60% was the most common reason of refusal, followed by nonviral cirrhosis. Fifty-four organs were used. Human hepatocyte isolation resulted in more that 7 million liver cells/g of tissue digested with 73% +/- 14% viability. Steatotic organs gave better results in terms of cell yield than cirrhotic livers. Isolated hepatocytes were able to perform specific liver functions, and evidence of factor IX and albumin messenger RNA (mRNA) production was reported when cells were plated in culture. Modifications of the traditional method of hepatocyte isolation, aimed at reducing ischemia-reperfusion damage and improving post-isolation cell conditions, showed improvements in post-isolation viability. In conclusion, we show that it is possible to use the vast majority of livers not suitable for transplantation on a national basis for human hepatocyte isolation, obtaining a large amount of viable functioning human hepatocytes that might be used for cell transplantation and therapy.

Cell Separation↗
PubMed2003

[Clinical usefulness and diagnostic value of percutaneous liver biopsy in patients with chronically elevated liver enzymes of non-viral origin].

BACKGROUND: In the context of increasing non-invasive diagnostic techniques the purpose of the present study was to determine the clinical usefulness and the diagnostic value of percutaneous liver biopsy in patients with chronically elevated liver enzymes of non-viral origin. PATIENTS AND METHODS: 100 patients from the outpatient clinic of the department of gastroenterology and hepatology who had a liver biopsy in the years 1996 to 1998 because of chronically elevated alanine-aminotransferase (ALT) and/or gamma-glutamyltransferase (gamma-GT) levels were included. Exclusion criteria were as follows: chronic hepatitis B or C infection, focal liver disease and clinical signs of hepatic decompensation. Retrospectively gained clinical data were independently evaluated by two experienced hepatologists. Initially, both examiners made a preliminary clinical diagnosis prior to knowing results from liver histology. With the results from liver histology both examiners were asked to make a final diagnosis. For each patient, the preliminary clinical diagnoses of both examiners were then correlated with the corresponding final diagnoses. RESULTS: Liver histology led in 71 % respectively 74 % of the patients to confirmation or specification of the clinical diagnosis. Liver biopsy was particularly helpful in differentiating non-decompensated liver cirrhosis, cryptogenic hepatitis, auto-immune hepatitis and biliary diseases. CONCLUSION: Despite improved non-invasive diagnostic tools including a broad spectrum of serologic tests liver biopsy is often indispensable for differentiating primary liver from biliary diseases and for the early detection of patients with liver cirrhosis.

Adult↗
PubMed1987

Markers of allograft viability in the rat. Relationship between transplantation viability and liver function in the isolated perfused liver.

The relationship between transplant viability and liver function has been examined. Wistar rat livers were preserved at 4 degrees C for increasing intervals and then transplanted into Wistar rat recipients. Two critical times were identified, the longest preservation period with 100% transplantation success (4 hr) and the shortest preservation period with 100% transplant failure (8 hr). The comparable critical times were also identified in livers preserved at 37 degrees C (1 hr and 2 hr). Liver functions were studied by the isolated perfused liver technique in other rat livers stored at 4 degrees C or 37 degrees C for the critical times. Two liver function tests, AST and LDH concentration in perfusate, discriminated between viable and nonviable livers across as well as within preservation groups. AST gave the best separation between viable and nonviable livers. Some functions such as ALT concentration in perfusate separated viable from non viable allografts only within preservation groups. Other liver functions were more sensitive to preservation temperature than allograft viability. Oxygen consumption after cold preservation for either critical time was about twice control levels. Urea production was far below control levels in warm-preserved livers but almost normal in cold-preserved livers. Our results indicate that AST release into perfusate can be used as a screening technique to optimize preservation methods, reserving transplantation for confirming the most promising results.

Animals↗
PubMed1991

The predictive value of donor liver biopsies for the development of primary nonfunction after orthotopic liver transplantation.

Methods of accurately assessing the suitability of donor livers prior to transplantation are required if the incidence of primary nonfunction (PNF) is to be reduced. This study evaluated the ability of donor liver biopsies to predict the development of primary nonfunction after transplantation. From June 1987 until May 1990, 170 liver transplants were performed in 147 patients. A total of 124 donor liver biopsies were obtained and divided into three groups. Group 1 biopsies (n = 77) were obtained after revascularization of the liver, group 2 biopsies (n = 19) were obtained prior to donor hepatectomy but examined only after implantation, and group 3 biopsies (n = 28) were obtained as in group 2, but were examined prior to implantation. Three of 89 (3.4%) livers interpreted as having normal histology developed primary nonfunction, while one of 26 (3.8%) biopsies interpreted as having a minimal or moderate amount of fatty infiltration developed primary nonfunction. PNF occurred in 7 of 8 livers with severe fatty infiltration (3), hydropic degeneration (3), and centrilobular necrosis (1). A fourth liver with hydropic degeneration and poor function ultimately failed requiring retransplantation 8 weeks later. Analysis of liver function revealed progressive elevation in aspartate-aminotransferase, alanine-aminotransferase, lactate dehydrogenase, and serum ammonia (NH3) with increasing degrees of fatty infiltration. Donor age and weight was also found to be significantly higher in livers with fatty infiltration. This study suggests that donor liver biopsies demonstrating normal histology or minimal-to-moderate fatty infiltration function adequately, but that donor livers with severe fatty infiltration or hydropic degeneration function poorly and should not be transplanted.

Biopsy↗
PubMed2006

Ex vivo adenoviral gene transfer of constitutively activated STAT3 reduces post-transplant liver injury and promotes regeneration in a 20% rat partial liver transplant model.

Signal transducer and activator of transcription-3 (STAT3) is one of the most important transcription factors for liver regeneration. This study was designed to examine the effects of constitutively activated STAT3 (STAT3-C) on post-transplant liver injury and regeneration in a rat 20% partial liver transplant (PLTx) model by ex vivo adenoviral gene transfer. Adenovirus encoding the STAT3-C gene was introduced intraportally into liver grafts and clamped for 30 min during cold preservation. After orthotopic PLTx, liver graft/body weights and serum biochemistry were monitored, and both a histological study and DNA binding assay were performed. STAT3-C protein expression and its binding to DNA in the liver graft were confirmed by Western blotting and electrophoretic mobility shift assay (EMSA), respectively. This treatment modality promoted post-Tx liver regeneration effectively and rapidly. The serum levels of alanine aminotransferase/aspartate aminotransferase (AST/ALT) and bilirubin decreased in rats with STAT3-C. However, albumin (a marker of liver function) did not. Ex vivo gene transfer of STAT3-C to liver grafts reduced post-Tx injury and promoted liver regeneration. Thus, the activation of STAT3 in the liver graft may be a potentially effective clinical strategy for improving the outcome of small-for-size liver transplantation.

Adenoviridae↗
PubMed2004

Liver regeneration using a hybrid artificial liver support system.

We have developed two types of hybrid artificial liver support system (HALSS) that use hepatocyte organoid culture: (1) a PUF-HALSS comprising an artificial liver module using polyurethane foam (PUF), in which hepatocytes form spheroids in its pores, and maintained liver-specific functions for at least ten days in vitro; (2) an LLS-HALSS that uses a liver lobule-like structure (LLS) module containing hollow fibers with a microregular arrangement in which hepatocytes in the extra-fiber space of the module form the organoids by centrifugation that maintain liver-specific functions for at least two months in vitro. In preclinical experiments, a PUF-HALSS was applied to a pig having liver failure. To evaluate the effect of liver regeneration, a PUF- and an LLS-HALSS were applied to a rat having reversible hepatic failure. Each HALSS was effective in supporting liver function, stabilization of general conditions and recovery from liver failure state. These results indicate that these HALSS may be useful to treat liver failure patients until liver transplantation or until regeneration of the native liver.

Animals↗
PubMed1996

Fatty acid composition of liver total lipids in alcoholic patients with and without liver damage.

Alcohol ingestion may promote lipid peroxidation, and the presence of polyunsaturated fatty acids in liver lipids may be essential for the generation of liver damage through this mechanism. The aim of this study is to examine fatty acid composition of liver lipids in chronic alcoholics with and without histological liver damage. A percutaneous liver biopsy was performed to 28 patients hospitalized for treatment of their alcoholism. Liver total lipids were extracted from a portion of the tissue sample and fatty acid composition was measured by gas chromatography. Another piece of the sample was sent for histological study. Six patients had histological cirrhosis or alcoholic hepatitis in their biopsies, the rest of the patients had minimal changes. Patients with liver damage had higher levels of oleic acid and total monoenoic fatty acids, a higher 18:1/18:0 ratio, lower levels of polyunsaturated fatty acids, a lower 20:4/18:2 ratio, and a lower peroxidability index in liver total lipids, than patients without liver damage. Alcoholic patients with asymptomatic liver damage have less unsaturated fatty acids in liver total lipids than their counterparts with normal livers.

Adult↗
PubMed1995

Evaluation of liver function tests to predict operative risk in liver surgery.

Despite numerous studies in the past it is not possible yet to predict postoperative liver failure and safe limits for hepatectomy. In this study the following liver function tests ICG-ER (indocyaninegreen elimination rate), GEC (galactose elimination capacity) and MEGX-F (monoethylglycinexylidid formation) are examined with regard to loss of liver tissue and prediction of operative risk. Liver function tests were assessed in 20 patients prior to liver resection and on the 10th. postoperative day. Liver and tumor volume were measured by ultrasound and pathologic specimen and the parenchymal resection rate was calculated. In patients without cirrhosis (n = 10) ICG-ER and MEGX-F remained unchanged after resection, GEC was reduced but did not correspond to the resection rate. Patients with cirrhosis (n = 10) had a significantly lower ICG-ER and GEC before resection than patients without cirrhosis. After resection these tests were unchanged. Patients with liver related complications and cirrhosis (n = 5) had lower ICG-ER and GEC than patients with cirrhosis and no complications. In the postoperative course all liver function tests in these patients were significantly lower compared to preoperative results. Comparing liver function tests ICG serves best to indicate postoperative liver failure. Liver function tests do not correspond with loss of liver tissue.

Galactose↗
PubMedDate not supplied

Radiotherapy of liver malignancies. From whole liver irradiation to stereotactic hypofractionated radiotherapy.

AIMS AND BACKGROUND: Until recently radiotherapy of hepatic malignancies has played a limited role due to the well-known limited radiotolerance of the liver. The aim of this paper is to review the available data on the risk of radiation-induced liver disease (RILD) and to define the modern role of radiotherapy in the management of patients with metastatic or primary liver malignancies. METHODS: The advent of three-dimensional conformal treatment planning with dose-volume histogram analysis has made the study of partial liver irradiation possible. Limited portions of the liver may withstand high doses of radiation with minimal risk of RILD. Patients with solitary unresectable liver tumors may be treated with high-dose radiotherapy with curative intent. Recently, the feasibility of stereotactically guided treatment techniques with a single fraction or few treatment sessions has been explored in numerous institutions. RESULTS: The radiation tolerance of the whole liver found by several investigations is in the order of approximately 30 Gy, which seriously restricts its clinical application. The role of whole liver irradiation therefore appears of limited benefit in the palliation of patients with multiple liver metastases. The use of three-dimensional conformal techniques has made partial liver irradiation possible to doses in the 70-80 Gy range with conventional fractionation. At least two published series have reported improved local control and survival rates with dose escalation with three-dimensional conformal radiotherapy in patients with unresectable liver metastases. Similar outcomes have been recently reported with single dose (or hypofractionated) stereotactic radiotherapy both in metastatic and primary hepatic malignancies with minimal morbidity. Accurate target delineation and treatment reproducibility are the key to the success of this novel treatment approach, and specific treatment planning techniques and patient setup procedures must be developed to implement it. CONCLUSIONS: Stereotactic high-dose radiotherapy is technically feasible for the treatment of inoperable liver malignancies, with the potential of high local control and low morbidity. Definitive evidence on the clinical advantages of this technique over other more established treatments can only be gathered from well-designed clinical studies.

Dose Fractionation, Radiation↗
PubMed1983

Ultrasonographical diagnosis of fatty liver: significance of the liver-kidney contrast.

In order to investigate the reliability of ultrasonography in the diagnosis of fatty liver, retrospective evaluation was made of abdominal echograms in 45 patients with various diffuse liver diseases who underwent liver biopsy within 2 weeks after the ultrasound study. Instead of the well-recognized but subjective diagnostic criterion, i.e. the bright liver pattern, liver-kidney contrast is proposed as a new criterion. The liver-kidney contrast is based on the brightness of the liver in comparison to the renal parenchyma where fatty change seldom occurs. Combination of this liver-kidney contrast with two other well-known ultrasonographical findings of fatty liver, vascular blurring and deep attenuation, enables us to grade fatty change semiquantitatively. When fatty change of over 30% in the hepatic lobule was adopted as the definition of fatty liver, the satisfaction of both liver-kidney contrast and vascular blurring presented an ultrasound diagnostic criterion for fatty liver, with sensitivity of 83%, specificity of 100%, and an accuracy of 96%.

Abdominal Muscles↗
PubMed2002

Usefulness of the tactile sensor for estimating the degree of liver fibrosis and the DNA synthesis activity of remnant liver cells after partial hepatectomy.

BACKGROUND/PURPOSE: Most patients with hepatocellular carcinoma in Japan also have liver cirrhosis. Therefore, reliable information about liver function is essential before undertaking liver resection. Occasionally preoperative estimates and intraoperative findings are disparate. This study used rats with liver fibrosis and a new tactile sensor to determine whether quantification of liver hardness intraoperatively can be used to validate the preoperative assessment of liver function prior to hepatectomy. METHODS: Liver fibrosis was induced by administration of thioacetamide to rats. Laparotomy was performed. In some rats, blood samples were taken for examination, and liver stiffness and tactile values were measured by a new tactile sensor. A biopsy specimen from each removed liver was taken, and the hepatic fibrosis index was measured by computed color image analysis after Azan blue staining. The other rats underwent partial hepatectomy, and the bromodeoxyuridine labeling index was calculated in them. Correlations between stiffness, tactile values, and other data were calculated. RESULTS: A strong correlation existed between stiffness and both the hepatic fibrosis index and the bromodeoxyuridine labeling index, and between tactile values and both the hepatic fibrosis index and the bromodeoxyuridine labeling index. CONCLUSIONS: Liver hardness proved to be a function of hepatic fibrosis. The tactile sensor proved to be an easy and reliable way to evaluate the hepatic fibrosis index. Quantification of liver hardness by tactile sensor predicted liver regenerative activity.

Animals↗
PubMed1998

Immunohistochemical localization of endothelin-1/big endothelin-1 in normal liver, liver cirrhosis and hepatocellular carcinoma.

In order to clarify the characteristics of cellular localization of ET-1/big ET-1 in liver tissues, we carried out immunohistochemical study on 30 normal, 87 cirrhosis (LC) and 55 hepatocellular carcinoma (HCC) liver specimens using anti-ET-1 antibody and anti-big ET-1 antibody and further performed in situ hybridization on 5 LC liver specimens. Positive immunostaining of hepatocytes of normal and LC livers, and tumor cells of HCC was obtained. The frequency of positive cells for ET-1 and big ET-1 of normal liver was very low. In contrast, LC hepatocytes were stained much more frequently for both ET-1 and big ET-1 than those of normal liver (P < 0.01). In the HCC livers hepatoma cells showed intermediate frequency of positive cells between normal and LC livers. Big ET-1, not ET-1, expression in HCC was significantly high compared with that of normal liver (P < 0.01). Specific signals for ET-mRNA were not detected in hepatocytes of LCs by in situ hybridization. ETs detected in hepatocytes by immunohistochemistry, therefore, seem not to have been synthesized locally. The origin of ETs is not clear but they might have been taken up from the circulation through ET receptors on hepatocytes. Although the clearance mechanism of ETs by ET-converting enzyme or other peptidases in liver has not been elucidated, the mechanisms seem to be absent or impaired in LC and/or HCC liver since the frequency and intensity of ET-positivity in the diseased hepatocytes are significantly high than those of normal liver. In addition, a disturbance of ET excretion into the bile may be also responsible for the ET storage. Elevation of serum ET levels in LC may be caused by disturbance of ET degradation and/or leakage of bile into the blood, as the ET is excreted through the biliary system.

Carcinoma, Hepatocellular↗
PubMed1999

[Importance of determination of monoethylglycinexylidide (MEGX)--as a liver function test in hepatology and liver transplantation].

Intravenously administered lidocaine is rapidly metabolised in the liver biotransformation enzyme system through oxidative N-deethylation with cytochrome P-450, accompanied by production of monoethylglycinexylide (MEGX). Changes of the activity and capacity of this sensitive system in liver diseases are expressed in disturbed metabolism of substances predominantly metabolised by this enzymatic system. Serum concentration of MEGX--a lidocaine metabolite--reflects the disturbance of liver function. The degree of liver function disturbance correlates with the rate of MEGX concentration fall. Utilization of MEGX test in clinical practice is multiple. In patients with chronic liver diseases is the MEGX test an appropriate complementary test enabling the evaluation of liver functional state with prognostic value. In the field of transplantology it may be used in pretransplantation period for donor liver functional state evaluation and in posttransplantation term for monitoring the graft functional state. The test was used in similar manner in paediatric patients. MEGX test is an appropriate method for rapid estimation of functional liver capacity in actual period. It is a rapid, simple test, which represents a complementary method in hepatology and liver transplantation. MEGX is worldwide used in detection of the functional liver state in patients with various forms of liver diseases and in patients prior to and after liver transplantation. (Ref. 46.)

Animals↗
PubMedDate not supplied

101 hepatectomies under continuous inflow occlusion following simple in-situ liver cooling in patients with chronic liver diseases.

BACKGROUND/AIMS: Hepatic inflow occlusion involves the serious disadvantage of ischemic injury to the remnant liver, particularly in patients with injured parenchyma. Liver hypothermia is one of the solutions for this problem. The purpose of this study was to evaluate simple in-situ liver cooling method of performing hepatic resection under continuous inflow occlusion in patients with chronic liver disease. METHODOLOGY: One hundred and one patients with chronic hepatitis (n = 26) and cirrhosis (n = 75) were included in this retrospective study. They underwent hepatectomy under conditions of continuous inflow occlusion immediately following simple in-situ liver cooling. Laboratory data and intraoperative and postoperative variables were analyzed for the three groups of patients stratified according to the lowest liver tissue temperature achieved: group 1 (> or = 30 degrees C, n = 16), group 2 (< 30 degrees C and > or = 25 degrees C, n = 62) and group 3 (< 25 degrees C, n = 20). RESULTS: Our simple in-situ liver cooling method enabled us to safely resect chronically diseased liver under continuous inflow occlusion (49.8 +/- 7.7 min, mean +/- SD; range, 30 to 70 min) with acceptable operative blood loss (894 +/- 853mL), morbidity (22.7%, 23/101) and mortality (1.0%, 1/101); one patient died of complications unrelated to ischemic injury. Analysis demonstrated that simple liver hypothermia was substantially hepatoprotective against ischemic injury in terms of serum transaminase levels and duration of inflow occlusion, particularly when the liver tissue temperature fell below 30 degrees C (groups 2 and 3). CONCLUSIONS: Hepatic inflow occlusion can be safely employed in a continuous manner for approximately 1 hour, even during resection of chronically diseased liver, particularly when the liver is cooled below 30 degrees C prior to hepatic clamping by our simple in-situ hypothermia technique.

Aged↗
PubMedDate not supplied

Liver damage score--a new index for evaluation of the severity of chronic liver diseases.

BACKGROUND/AIMS: Many hepatologists believe that the Child's classification is not the ultimate prognostic tool for liver disease. Our aim was to develop an index for the estimation of the severity of liver damage, to evaluate its predictive power for the short-term and long-term prognosis of patients with chronic liver disease, and for the estimation of the effect of different therapeutic regimens. METHODOLOGY: The Liver Damage Score (LDS) was developed based on the analysis of the laboratory data of 151 randomly selected patients with liver diseases. Variables for reduced protein synthesis, increased production of antibodies, cytolysis, cholestasis, functional renal failure were combined into LDS according to the results of cluster analysis. The evaluation of the liver injury was analyzed in 696 patients with different liver diseases. RESULTS: There are three groups of liver diseases: mild-with LDS of 1-2 U, moderate with LDS 3-4.5 U and severe with LDS > 5.0 U. There was a good correlation between the LDS and the scores for liver cirrhosis. Values above 4-6 U carry bad prognosis. The LDS truthfully reflects the evolution of liver diseases over time and the effect of therapy. CONCLUSION: The LDS is a new, simple, low-cost, biomathematically and pathophysiologically based index, useful for monitoring practically all patients with liver diseases, no matter what the etiology and stage of the liver injury is. It allows a quantitative expression of the disease severity and the improvement or deterioration in its course.

Chronic Disease↗
PubMed1998

Circulating neutrophils and liver injury in rat models of experimental alcoholic liver disease.

The present study examined the relationship between circulating neutrophils and liver injury in two widely used rat models of chronic ethanol administration. Hematological alterations, liver histopathology, and biochemical indices of liver injury were assessed in rats receiving chronic ethanol by oral liquid diet feeding (Lieber-DeCarli method) or by continuous intragastric infusion (Tsukamoto-French method). Oral administration of ethanol did not affect circulating neutrophil counts, but resulted in minimal liver injury characterized by elevated serum alanine aminotransferase (79%), increased liver mass (15%), and moderate steatosis. In contrast, rats receiving ethanol by continuous intragastric infusion showed an approximately 2-fold increase in circulating neutrophils, and a moderate degree of liver injury, indicated by a 169% elevation of serum alanine aminotransferase and a 2-fold increase in liver mass. Liver biopsies from these rats showed severe steatosis and scattered necrotic hepatocytes, and some neutrophil infiltrates. To determine whether an increase in the number of circulating neutrophils could potentiate liver injury induced by oral ethanol feeding, rats were treated with human recombinant granulocyte colony-stimulating factor at a dose of 100 microg/kg/day (s.c.) for 4 days. Treatment with granulocyte colony-stimulating factor resulted in a 6- to 9-fold increase in circulating neutrophil counts. Nevertheless, this change did not enhance the minor degree of ethanol-induced liver injury in this model. Our results indicate that, whereas neutrophil leukocytosis accompanies more severe manifestations of ethanol hepatotoxicity in rats, this condition per se does not directly induce or exacerbate ethanol-induced liver injury.

Animals↗
PubMed2001

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.

Journal Article↗