Value of Serum Leptin Level in Patients with Decompensated Liver Cirrhosis and Hepatocellular Carcinoma

Abstract

SUMMARY H CC is the most common type of liver cancer, and the second common type of cancers affecting the gastrointestinal tract, after gastric cancer (Zhu et al., 2013). The association of MS with malignancy attracted more and more attentions. As inevitable consequence of IR, hyperinsulinemia plays an important role in occurrence and prognosis of cancer (Chung et al., 2004). Leptin, the product of the obese (ob) gene, mainly produced by adipose tissues and, to a lesser extent, by tissues such as the skeletal tissue and placenta. Leptin is a pro-angiogenic, pro-inflammatory and mitogenic factor, the actions of which are reinforced through crosstalk with IL-1 family cytokines in cancercenogenesis (Perrier et al., 2009). Based on analysis of liver tissue samples, somatic mutations accumulate in leptin receptor gene (LEPR) in cirrhotic liver with chronic HCV infection. These mutations could disrupt LEPR signaling and increase susceptibility to hepatocarcinogenesis (Ikeda et al., 2014). There is direct relationship between leptin and insulin resistance, so that an increase in blood leptin concentration can lead to insulin resistance (Rudzka-Kocjan et al., 2006). The aim of this study is to determine the value of serum leptin assessment in patients with HCV related liver cirrhosis and patients with hepatocellular carcinoma. This study was conducted at the gastroenterology and Hepatology unit, department of internal medicine, Ain Shams University. 90 Egyptian patients with HCV related end stage liver disease were recruited and were divided into 2 groups:  Group I: 50 patients with end stage liver disease and well established diagnosis of HCC.  Group II: 40 patients with HCV related cirrhosis. HCC was excluded in these patients at time of recruitment in the study. All participants were subjected to history taking, clinical examination, laboratory investigations, abdominal ultrasonography, and measurement of fasting serum insulin and serum leptin levels. This study revealed highly significant higher serum leptin; fasting insulin and HOMA-IR were found in patients with HCC than in cirrhotic HCV patients. These results strongly points to the potential role of leptin and leptin resistance in the pathogenesis of HCC.