Circulating leptin in non-alcoholic fatty liver disease: a systematic review and meta-analysis

Springer Science and Business Media LLC - Tập 59 - Trang 30-43 - 2015
Stergios A. Polyzos1, Konstantinos N. Aronis2,3, Jannis Kountouras1, Dimitrios D. Raptis1, Maria F. Vasiloglou1, Christos S. Mantzoros2,3,4
1Second Medical Clinic, Department of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece
2Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
3Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, USA
4Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, USA

Tóm tắt

Clinical data regarding circulating leptin levels in patients with non-alcoholic fatty liver disease (NAFLD) are conflicting. The purpose of this meta-analysis was to compare leptin levels between the following groups: patients with biopsy-proven NAFLD vs controls; simple steatosis (SS) patients vs controls; non-alcoholic steatohepatitis (NASH) patients vs controls and NASH patients vs SS patients. We performed a systematic search in PubMed, Scopus and the Cochrane Library. We analysed 33 studies, published between 1999 and 2014, including 2,612 individuals (775 controls and 1,837 NAFLD patients). Higher circulating leptin levels were observed in NAFLD patients vs controls (standardised mean difference [SMD] 0.640; 95% CI 0.422, 0.858), SS patients vs controls (SMD 0.358; 95% CI 0.043, 0.673), NASH patients vs controls (SMD 0.617; 95% CI 0.403, 0.832) and NASH patients vs SS patients (SMD 0.209; 95% CI 0.023, 0.395). These results remained essentially unchanged after excluding studies involving paediatric or adolescent populations and/or individuals undergoing bariatric surgery. There was moderate-to-severe heterogeneity among studies in all comparisons, but no significant publication bias was detected. Meta-regression analysis demonstrated that BMI was inversely associated with leptin SMD and accounted for 26.5% (p = 0.014) and 32.7% (p = 0.021) of the between-study variance in the comparison between NASH patients and controls and NAFLD patients and controls, respectively. However, when bariatric studies were excluded, BMI did not significantly explain the between-study variance. Circulating leptin levels were higher in patients with NAFLD than in controls. Higher levels of circulating leptin were associated with increased severity of NAFLD, and the association remained significant after the exclusion of studies involving paediatric or adolescent populations and morbidly obese individuals subjected to bariatric surgery.

Tài liệu tham khảo

Polyzos SA, Kountouras J, Zavos C (2009) Nonalcoholic fatty liver disease: the pathogenetic roles of insulin resistance and adipocytokines. Curr Mol Med 72:299–314 Vernon G, Baranova A, Younossi ZM (2011) Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 34:274–285 Kelesidis T, Kelesidis I, Chou S, Mantzoros CS (2010) Narrative review: the role of leptin in human physiology: emerging clinical applications. Ann Intern Med 152:93–100 Moon HS, Dalamaga M, Kim SY et al (2013) Leptin’s role in lipodystrophic and nonlipodystrophic insulin-resistant and diabetic individuals. Endocr Rev 34:377–412 Mantzoros CS, Magkos F, Brinkoetter M et al (2011) Leptin in human physiology and pathophysiology. Am J Physiol Endocrinol Metab 301:E567–E584 Dalamaga M, Chou SH, Shields K, Papageorgiou P, Polyzos SA, Mantzoros CS (2013) Leptin at the intersection of neuroendocrinology and metabolism: current evidence and therapeutic perspectives. Cell Metab 18:29–42 Polyzos SA, Kountouras J, Zavos C, Deretzi G (2011) The potential adverse role of leptin resistance in nonalcoholic fatty liver disease: a hypothesis based on critical review of literature. J Clin Gastroenterol 45:50–54 Imajo K, Fujita K, Yoneda M et al (2012) Hyperresponsivity to low-dose endotoxin during progression to nonalcoholic steatohepatitis is regulated by leptin-mediated signaling. Cell Metab 16:44–54 Polyzos SA, Kountouras J, Mantzoros CS (2015) Leptin in nonalcoholic fatty liver disease: a narrative review. Metabolism 64:60–78 Polyzos SA, Mantzoros CS (2014) Necessity for timely noninvasive diagnosis of nonalcoholic fatty liver disease. Metabolism 63:161–167 Polyzos SA, Mantzoros CS (2015) Leptin in health and disease: facts and expectations at its twentieth anniversary. Metabolism 64:5–12 Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012 Polyzos SA, Toulis KA, Goulis DG, Zavos C, Kountouras J (2011) Serum total adiponectin in nonalcoholic fatty liver disease: a systematic review and meta-analysis. Metabolism 60:313–326 Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander-Tetri BA, Bacon BR (1999) Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol 94:2467–2474 Kleiner DE, Brunt EM, Van NM et al (2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41:1313–1321 Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269 Angulo P, Alba LM, Petrovic LM, Adams LA, Lindor KD, Jensen MD (2004) Leptin, insulin resistance, and liver fibrosis in human nonalcoholic fatty liver disease. J Hepatol 41:943–949 Argentou M, Tiniakos DG, Karanikolas M et al (2009) Adipokine serum levels are related to liver histology in severely obese patients undergoing bariatric surgery. Obes Surg 19:1313–1323 Canbakan B, Tahan V, Balci H et al (2008) Leptin in nonalcoholic fatty liver disease. Ann Hepatol 7:249–254 Cayon A, Crespo J, Mayorga M, Guerra A, Pons-Romero F (2006) Increased expression of Ob-Rb and its relationship with the overexpression of TGF-β1 and the stage of fibrosis in patients with nonalcoholic steatohepatitis. Liver Int 26:1065–1071 Chalasani N, Crabb DW, Cummings OW et al (2003) Does leptin play a role in the pathogenesis of human nonalcoholic steatohepatitis? Am J Gastroenterol 98:2771–2776 Charlton M, Angulo P, Chalasani N et al (2008) Low circulating levels of dehydroepiandrosterone in histologically advanced nonalcoholic fatty liver disease. Hepatology 47:484–492 Chitturi S, Farrell G, Frost L et al (2002) Serum leptin in NASH correlates with hepatic steatosis but not fibrosis: a manifestation of lipotoxicity? Hepatology 36:403–409 Dasarathy S, Yang Y, McCullough AJ, Marczewski S, Bennett C, Kalhan SC (2011) Elevated hepatic fatty acid oxidation, high plasma fibroblast growth factor 21, and fasting bile acids in nonalcoholic steatohepatitis. Eur J Gastroenterol Hepatol 23:382–388 Fitzpatrick E, Dew TK, Quaglia A, Sherwood RA, Mitry RR, Dhawan A (2012) Analysis of adipokine concentrations in paediatric non-alcoholic fatty liver disease. Pediatr Obes 7:471–479 Giannini E, Botta F, Cataldi A et al (1999) Leptin levels in nonalcoholic steatohepatitis and chronic hepatitis C. Hepatogastroenterology 46:2422–2425 Gonciarz M, Bielanski W, Partyka R et al (2013) Plasma insulin, leptin, adiponectin, resistin, ghrelin, and melatonin in nonalcoholic steatohepatitis patients treated with melatonin. J Pineal Res 54:154–161 Haukeland JW, Dahl TB, Yndestad A et al (2012) Fetuin A in nonalcoholic fatty liver disease: in vivo and in vitro studies. Eur J Endocrinol 166:503–510 Huang XD, Fan Y, Zhang H et al (2008) Serum leptin and soluble leptin receptor in non-alcoholic fatty liver disease. World J Gastroenterol 14:2888–2893 Hui JM, Hodge A, Farrell GC, Kench JG, Kriketos A, George J (2004) Beyond insulin resistance in NASH: TNF-alpha or adiponectin? Hepatology 40:46–54 Kashyap SR, Diab DL, Baker AR et al (2009) Triglyceride levels and not adipokine concentrations are closely related to severity of nonalcoholic fatty liver disease in an obesity surgery cohort. Obesity (Silver Spring) 17:1696–1701 Koehler E, Swain J, Sanderson S, Krishnan A, Watt K, Charlton M (2012) Growth hormone, dehydroepiandrosterone and adiponectin levels in non-alcoholic steatohepatitis: an endocrine signature for advanced fibrosis in obese patients. Liver Int 32:279–286 Le D, Marks D, Lyle E et al (2007) Serum leptin levels, hepatic leptin receptor transcription, and clinical predictors of non-alcoholic steatohepatitis in obese bariatric surgery patients. Surg Endosc 21:1593–1599 Lemoine M, Ratziu V, Kim M et al (2009) Serum adipokine levels predictive of liver injury in non-alcoholic fatty liver disease. Liver Int 29:1431–1438 Machado MV, Coutinho J, Carepa F, Costa A, Proenca H, Cortez-Pinto H (2012) How adiponectin, leptin, and ghrelin orchestrate together and correlate with the severity of nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 24:1166–1172 Manco M, Giordano U, Turchetta A et al (2009) Insulin resistance and exercise capacity in male children and adolescents with non-alcoholic fatty liver disease. Acta Diabetol 46:97–104 Munoz LE, Cordero P, Torres L, Sauceda AY, Flores JP, Segura JJ (2009) Adipokines in a group of Mexican patients with nonalcoholic steatohepatitis. Ann Hepatol 8:123–128 Musso G, Gambino R, Durazzo M et al (2005) Adipokines in NASH: postprandial lipid metabolism as a link between adiponectin and liver disease. Hepatology 42:1175–1183 Nobili V, Manco M, Ciampalini P et al (2006) Leptin, free leptin index, insulin resistance and liver fibrosis in children with non-alcoholic fatty liver disease. Eur J Endocrinol 155:735–743 Pagano C, Soardo G, Esposito W et al (2005) Plasma adiponectin is decreased in nonalcoholic fatty liver disease. Eur J Endocrinol 152:113–118 Petta S, Amato MC, Di Marco V et al (2012) Visceral adiposity index is associated with significant fibrosis in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther 35:238–247 Pirvulescu I, Gheorghe L, Csiki I et al (2012) Noninvasive clinical model for the diagnosis of nonalcoholic steatohepatitis in overweight and morbidly obese patients undergoing bariatric surgery. Chirurgia (Bucur) 107:772–779 Polyzos SA, Kountouras J, Anastasilakis AD, Geladari EV, Mantzoros CS (2014) Irisin in patients with nonalcoholic fatty liver disease. Metabolism 63:207–217 Singh DK, Sakhuja P, Rastogi A, Singh A, Gondal R, Sarin SK (2013) Serum leptin levels correlate with body mass index but not with histologic disease severity in Indian patients with non-alcoholic steatohepatitis: a pilot study. Indian J Med Res 137:986–987 Swellam M, Hamdy N (2012) Association of nonalcoholic fatty liver disease with a single nucleotide polymorphism on the gene encoding leptin receptor. IUBMB Life 64:180–186 Tungtrongchitr R, Treeprasertsuk S, Ei NN, Thepouyporn A, Phonrat B, Huntrup A (2006) Serum leptin concentrations in chronic hepatitis. J Med Assoc Thail 89:490–499 Uygun A, Kadayifci A, Yesilova Z et al (2000) Serum leptin levels in patients with nonalcoholic steatohepatitis. Am J Gastroenterol 95:3584–3589 Wong VW, Hui AY, Tsang SW et al (2006) Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 4:1154–1161 Yalniz M, Bahcecioglu IH, Ataseven H et al (2006) Serum adipokine and ghrelin levels in nonalcoholic steatohepatitis. Mediat Inflamm 2006:34295 Egger M, Juni P, Bartlett C, Holenstein F, Sterne J (2003) How important are comprehensive literature searches and the assessment of trial quality in systematic reviews? Empirical study. Health Technol Assess 7:1–76