Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 14, 2011; 17(46): 5097-5104
Published online Dec 14, 2011. doi: 10.3748/wjg.v17.i46.5097
Serum leptin and ghrelin in chronic hepatitis C patients with steatosis
Christos Pavlidis, Georgios I Panoutsopoulos, Dina Tiniakos, Sotirios Koutsounas, John Vlachogiannakos, Irini Zouboulis-Vafiadis
Christos Pavlidis, John Vlachogiannakos, Irini Zouboulis-Vafiadis, First Department of Propaedeutic Medicine “LAIKO” General Hospital, Agiou Thoma 17, Athens 11527, Greece
Georgios I Panoutsopoulos, Department of Nursing, University of Peloponnese, Orthias Artemidos and Plateon, Sparta, Lakonia 23100, Greece
Dina Tiniakos, Laboratory of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Athens 11527, Greece
Sotirios Koutsounas, Reference Center for Viral Hepatitis, IKA, Athens 10436, Greece
Author contributions: Pavlidis C and Panoutsopoulos GI contributed equally to this work; Pavlidis C and Zoumboulis-Vafiadis I designed the study; Pavlidis C, Zoumboulis-Vafiadis I, Tiniakos D and Koutsounas S performed the study; Panoutsopoulos GI analyzed the data; Pavlidis C, Panoutsopoulos GI, Zoumboulis-Vafiadis I, Tiniakos D and Vlachogiannakos J wrote the manuscript.
Correspondence to: Dr. Christos Pavlidis, First Department of Propaedeutic Medicine “LAIKO” General Hospital, Agiou Thoma 17, Athens 11527, Greece.
Telephone: +30-210-6002252 Fax: +30-266-1046106
Received: January 2, 2011
Revised: May 3, 2011
Accepted: May 10, 2011
Published online: December 14, 2011

AIM: To determine the associations between leptin and ghrelin concentrations and sustained virological response (SVR) in chronic hepatitis C patients with steatosis.

METHODS: We retrospectively assessed 56 patients infected with hepatitis C virus (HCV) genotype-1 and 40 with HCV genotype-3. Patients with decompensated cirrhosis, and those with other causes of chronic liver disease, were excluded. Serum HCV-RNA concentrations were measured before the initiation of treatment; at weeks 12 (for genotype 1 patients), 24 and 48 during treatment; and 24 wk after the end of treatment. Genotype was determined using INNO-LIPA HCV assays, and serum leptin and ghrelin concentrations were measured using enzyme-linked immunosorbent assay. Biopsy specimens were scored according to the Ishak system and steatosis was graded as mild, moderate, or severe, according to the Brunt classification.

RESULTS: Overall, SVR was positively related to the presence of genotype-3, to biopsy-determined lower histological stage of liver disease, and lower grade of steatosis. Patients ≥ 40 years old tended to be less responsive to therapy. In genotype-1 infected patients, SVR was associated with a lower grade of liver steatosis, milder fibrosis, and an absence of insulin resistance. Genotype-1 infected patients who did not achieve SVR had significantly higher leptin concentrations at baseline, with significant increases as the severity of steatosis worsened, whereas those who achieved SVR had higher ghrelin concentrations. In genotype-3 infected patients, SVR was associated only with fibrosis stage and lower homeostasis model assessment insulin resistance at baseline, but not with the degree of steatosis or leptin concentrations. Genotype-3 infected patients who achieved SVR showed significant decreases in ghrelin concentration at end of treatment. Baseline ghrelin concentrations were elevated in responders of both genotypes who had moderate and severe steatosis.

CONCLUSION: Increased serum leptin before treatment may predict non-SVR, especially in HCV genotype-1 infected patients, whereas increased ghrelin may predict SVR in genotype-1.

Keywords: Hepatitis C virus, Steatosis, Leptin, Ghrelin, Sustained virological response