Serum leptin level and the severity of liver fibrosis in chronic hepatitis B and the effects of Peginterferon Alfa-2a treatment

Objective To evaluate the relationship of serum leptin levels and severity of liver inflammation and fibrosis in patients with chronic hepatitis B. Methods Serum leptin levels were determined in 40 patients with histologically proven chronic hepatitis B and 20 cases of healthy controls by enzyme linked immunosorbent assay. 20 of the 40 patients received 48 weeks of Peginterferon Alfa-2a (40 kD) treatment and liver biopsies were done at the beginning and in 24 weeks of follow-up. The histological response were assessed according to modified Scheuer staging and Chevallier's scoring system. Serum leptin levels in all of the 60 samples were analyzed compared with the liver inflammation grade and fibrosis stage.Results Serum leptin was increased significantly in patients with hepatitis B compared with the healthy controls (12.89±7.47) ng/ml vs (2.57±1.29) ng/ml, P 0.01 ). In patients with fibrosis staging 0 through 4, leptin levels were (2.62±0.89) ng/ml, (5.26±1.60) ng/ml, (13.15±4.52) ng/ml, ( 17.08 ± 3.78 ) ng/ml and (21.56±5.89) ng/ml, respectively, showing a positive correlation with hepatic fibrosis staging (r= 0.845 ,P 0.01 ). In 20 patients treated with Peginterferon Alfa-2a, fibrosis score decreased from 10.91±6.32 to 7.43±4.15(P=0.047),serum leptin level decreased significantly from 18.35±4.93 to 13.57±5.39(P=0.006). In patients with inflammation grading 0 through 4, leptin levels were 2.66 ±1.030 ng/ml,9.04±4.92 ng/ml,13.22±7.38 ng/ml,16.19±7.71 ng/ml,17.41±4.25 ng/ml,respectively. There was no significant difference in serum leptin between inflammation grade 2 through 4, but leptin levels in grade 3 and 4 were significantly higher than grade 1. Conclusion Serum leptin level is correlated with the severity of liver fibrosis in chronic hepatitis B and decreased after Peginterferon Alfa-2a treatment.