TIPS Implantation Raises Leptin Levels in Patients with Liver Cirrhosis
| Autor: | A. Buchwald, U. Leonhardt, Scholz Kh, Ramadori G, W Nolte, Wirtz M, Rossbach C |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Leptin Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Endocrinology Diabetes and Metabolism medicine.medical_treatment Nutritional Status Adipose tissue Gastroenterology Statistics Nonparametric Body Mass Index 03 medical and health sciences 0302 clinical medicine Endocrinology Liver Function Tests Internal medicine Internal Medicine medicine Humans Insulin In patient Aged 030304 developmental biology 2. Zero hunger 0303 health sciences medicine.diagnostic_test business.industry Malnutrition Stent General Medicine Middle Aged medicine.disease 3. Good health Peripheral Adipose Tissue Female 030211 gastroenterology & hepatology Portasystemic Shunt Transjugular Intrahepatic Liver function tests business Body mass index |
| Zdroj: | Experimental and Clinical Endocrinology & Diabetes. 111:435-442 |
| ISSN: | 1439-3646 0947-7349 |
| Popis: | Increased leptin levels in patients with liver cirrhosis are postulated to result in malnutrition and increased energy expenditure. Since cirrhotic patients show improved nutritional status after a transjugular intrahepatic portosystemic stent shunt (TIPS), it was the aim of this study to evaluate plasma leptin levels and their influence on nutritional status prior to and after the TIPS procedure. We evaluated plasma leptin levels, body mass index (BMI), Child-Pugh score and pertinent biochemical parameters in 31 patients (19 men and 12 women) with severe complications of liver cirrhosis (74% ethyltoxic men, 50% ethyltoxic in women), prior to and after TIPS. Nineteen cirrhotic patients without TIPS served as controls. In women ascitic-free BMI significantly increased (from 22.8 +/- 4.6 kg/m2 to 23.9 +/- 4.9; p = 0.004 three months after TIPS), whereas in men only a tendency toward higher values (26.1 +/- 4.7 vs. 26.7 +/- 4.4; p = 0.28) was found. Analysis of peripheral venous leptin concentrations before and three months after TIPS revealed a significant increase in women (11.9 +/- 8.8 ng/ml vs. 18.6 +/- 14.9; p = 0.009) and in men (7.7 +/- 6.2 ng/ml vs. 12.2 +/- 9.0; p = 0.005). In addition, the leptin-BMI ratio increase significantly in women and men three months after TIPS implantation (women 0.49 +/- 0.29 vs. 0.73 +/- 0.52; p = 0.017; men 0.28 +/- 0.22 vs. 0.43 +/- 0.28; p = 0.002). On the other hand, patients without TIPS implantation showed no significant alterations of BMI and peripheral venous leptin concentrations. After TIPS implantation in liver cirrhotic patients, leptin levels were increased and the nutritional status improved. Therefore, our analysis suggests that in patients with predominantly ethyltoxic liver cirrhosis, elevated leptin levels are not a major reason for poorer body composition. |
| Databáze: | OpenAIRE |
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