Objectives: The adipose tissue can play active proinflammatory and profibrogenic role in pathogenesis of chronic hepatitis C (CHC). Leptin seems to play important, although not fully elucidated, role in pathogenesis of liver damage.
Aim of the work: to investigate the relationship between serum leptin concentrations and the degree of hepatic fibrosis in patients infected with hepatitis C virus and to assess whether leptin level is affected by the combined antiviral treatment treatment when estimated 12 weeks after the start of treatment.
Patients and methods: 40 patients with CHC together with 10 healthy control subjects were enrolled in the study. Leptin level was estimated in these subjects at baseline and after 12 weeks from the start of combined antiviral therapy. Patients had liver biopsy taken at baseline to determine the fibrosis and inflammation grades according to the METAVIR study, 1994.
Results: Leptin concentration at baseline showed no significant difference between patients and control group (P> 0.05). Leptin level was much higher in female patients (36.1 ± 23.6) than in males (10.4 ± 9.9) (P< 0.05) at baseline group but not in the treated group. A high significant positive correlation was found between serum leptin level, inflammation grades and fibrosis stages (r= 0.810, p < 0.001 & r= 0.791, p < 0.001 respectively). Serum leptin concentrations in patients treated by combined antiviral therapy for 12 weeks is decreased more than baseline group with a mean ± SD of (8.8 ± 11.1 & 14.9 ± 16.3 respectively) although not reaching a statistically significant levels (P=0.054). Conclusion: Leptin has a profibrogenic and/or proinflammatory role as higher leptin levels were correlated with fibrosis stages and inflammation grades in CHC patients. Interferon-alpha antiviral therapy can decrease and suppress leptin levels in CHC patients