The Levels of Ghrelin, Leptin, TNF-α, and IL-6 in Liver Cirrhosis and Hepatocellular Carcinoma due to HBV and HDV Infection

摘要

Background/Aim. Malnutrition, a common problem in livercirrhosis and HCC, may readily deteriorate the clinical functionswith resultant poor prognosis. Beside the hyper catabolic statefrequently encountered in chronic liver disease and HCC, anorexiaand reduced food intake also worsen the malnutrition. The recentlydiscovered peptide hormone ghrelin acts as a counterpart of leptinin regulation of food intake and fat utilization. The aim of thepresent study was to investigate the ghrelin and leptin levels incirrhosis and HCC due to hepatitis B and D viruses, and theassociation of ghrelin and leptin with TNF-α, IL-6 and the severity of the disease.Materials and methods. Wemeasured serum ghrelin, leptin, TNF-α, and IL-6 levels using specific immunoassay in 45 patients (23 cirrhosis, 22 HCC)with HBV and/or HDV and in 25 control subjects.Results.In comparison to controls, serum ghrelin, TNF-α, and IL-6 levels were significantly higher in cirrhosis and HCC (P<.05), whereas serum leptin levels were found decreased (P<.05). There was a positive correlation between ghrelin and TNF-α, and a negative correlation between leptin and TNF-α(P<.05).Conclusion. In cirrhosis and HCC due to HBV or HDV, serumghrelin levels were increased with a corresponding decrease inserum leptin concentrations, acting as a physiological counterpartof ghrelin. The increasing of ghrelin is more prominent in ChildC cirrhosis and the level was correlated with TNF-α. The presence of nutritional and metabolic abnormalities, includingmalnutrition, in cirrhosis and HCC may, at least partly, elucidate high ghrelin and low leptin levels.