Serum leptin and ghrelin in chronic hepatitis C patients with steatosis

Table 1 Clinical, virological, and histological data of the study population (mean ± SD) n (%)

	SVR (n = 62)	Non-SVR (n = 34)	P-value
Age	35.01 ± 1.57	39.21 ± 2.07	0.050
Sex (male/female)	36/26	21/13
BMI	24.700 ± 0.179	25.530 ± 0.637	0.060
Genotype-1	32 (57.1)	24 (42.9)
Genotype-3	30 (75)	10 (25)
Stage (0-6)	1.661 ± 0.095	2.412 ± 0.141	< 0.001
Grade (0-18)	5.371 ± 0.136	5.265 ± 0.204	NS
Steatosis (1-3)	1.565 ± 0.082	2.060 ± 0.126	0.001

NS: Non-significant; SVR: Sustained virological response; BMI: Body mass index.

Table 2 Distribution of 56 genotype-1 and 40 genotype-3-infected patients by demographic, host and viral factors with respect to response to hepatitis C virus therapy (mean ± SD) n (%)

Variable	Genotype 1 (n = 56)			Genotype 3 (n = 40)
	Responders(n = 32)	Non-responders(n = 24)	P value	Responders(n = 30)	Non-responders(n = 10)	P-value
Gender			0.70			0.47
Male	15 (46.9)	10 (41.7)		13 (43.3)	6 (60.0)
Female	17 (53.1)	14 (58.3)		17 (56.7)	4 (40.0)
Age (yr)			0.17			0.15
≤ 40	23 (71.9)	13 (54.2)		29 (96.7)	8 (80.0)
> 40	9 (28.1)	11 (45.8)		1 (3.3)	2 (20.0)
Body mass index (kg/m2)			0.28			0.42
< 25	18 (56.3)	10 (41.7)		23 (76.7)	6 (60.0)
25-28	14 (43.7)	14 (58.3)		7 (23.3)	4 (40.0)
Grade of hepatic steatosis			0.0001			0.72
Mild	22 (68.7)	5 (20.8)		12 (40.0)	3 (30.0)
Moderate	10 (31.3)	12 (50.0)		13 (43.3)	4 (40.0)
Severe	0 (0.0)	7 (29.2)		5 (16.7)	3 (30.0)
Fibrosis score			0.001			0.04
1	17 (53.1)	3 (12.5)		16 (53.3)	1 (10.0)
2	11 (34.4)	8 (33.3)		11 (36.7)	7 (70.0)
3-4	4 (12.5)	13 (54.2)		3 (10.0)	2 (20.0)
5-6	0	0		0	0
HOMA-IR			0.01			0.01
< 2	11 (34.4)	4 (16.7)		19 (63.3)	1 (10.0)
2-3	10 (31.2)	2 (8.3)		10 (33.3)	7 (70.0)
> 3	11 (34.4)	18 (75.0)		1 (3.3)	2 (20.0)
Leptin_baseline (ng/mL)	37.66 ± 10.39	49.67 ± 13.44	0.001	24.33 ± 7.98	28.20 ± 9.72	0.22
Ghrelin_baseline (ng/mL)	0.286 ± 0.167	0.190 ± 0.119	0.02	0.778 ± 0.654	0.564 ± 0.324	0.18
Leptin end of follow-up (ng/mL)	26.69 ± 11.77	41.50 ± 16.24	< 0.0001	23.27 ± 9.54	26.70 ± 6.82	0.30
Ghrelin end of follow-up (ng/mL)	0.456 ± 0.254	0.239 ± 0.213	0.001	0.420 ± 0.321	0.450 ± 0.261	0.79

HOMA-IR: Homeostasis model assessment insulin resistance.

Table 3 Leptin and ghrelin concentrations at baseline and end of follow-up in patients infected with hepatitis C virus genotypes-1 and -3 by response to therapy, as well as mixed effect model derived estimates of differences in mean scores (mean ± SD)

Variable	Responders	Non-responders	P-value for the adjusted difference1
Leptin
Baseline (ng/mL)	30.99 (9.185)	38.43 (11.58)	NS
End of Follow-up (ng/mL)	23.76 (8.055)	34.10 (11.53)	0.01
Ghrelin
Baseline (ng/mL)	0.532 (0.410)	0.377 (0.223)	0.01
End of Follow-up (ng/mL)	0.438 (0.288)	0.345 (0.237)	0.05

¹Adjusted for both leptin and ghrelin concentrations. NS: Non-significant.

Table 4 Leptin and ghrelin concentrations at baseline and at end of follow-up by response to treatment in patients with hepatitis C virus genotypes-1 and -3, as well as mixed effect model derived estimates of the differences in mean scores (mean ± SD)

Variable	Baseline	End of follow-up	P-value for the adjusted difference1
Genotype 1 SVRs
Leptin (ng/mL)	37.66 (10.39)	26.69 (11.77)	0.001
Ghrelin (ng/mL)	0.286 (0.167)	0.456 (0.254)	0.001
Genotype 1 non-SVRs
Leptin (ng/mL)	49.67 (13.44)	43.58 (16.17)	0.060
Ghrelin (ng/mL)	0.190 (0.119)	0.239 (0.213)	0.320
Genotype 3 SVRs
Leptin (ng/mL)	24.33 (7.98)	23.27 (9.54)	0.510
Ghrelin (ng/mL)	0.778 (0.654)	0.420 (0.321)	0.001
Genotype 3 non-SVRs
Leptin (ng/mL)	28.20 (9.72)	26.70 (6.82)	0.610
Ghrelin (ng/mL)	0.564 (0.324)	0.450 (0.261)	0.470

¹Adjusted for both leptin and ghrelin concentrations.

Table 5 Multiple logistic regression derived odds ratios and 95% confidence intervals for response to hepatitis C virus therapy among patients infected with hepatitis C virus genotype-1 with respect to hepatic steatosis, and leptin and ghrelin concentrations at baseline and at end of follow-up

Variable	Category or increment	ORs	95% CIs	P-value
At baseline
Hepatic steatosis	1 level more	0.12	0.02-0.66	0.01
Leptin	10 ng/mL more	0.43	0.22-0.83	0.01
Ghrelin	0.1 ng/mL more	1.11	0.67-2.01	0.63
HOMA-IR	1 level more	1.34	0.42-4.31	0.63
Alternatively introduced variables
Fibrosis	1 level more	0.36	0.13 -0.96	0.04
Leptin	10 ng/mL more	0.45	0.24-0.86	0.02
Ghrelin	0.1 ng/mL more	1.35	0.82-2.45	0.26
HOMA-IR	1 level more	0.96	0.33-2.79	0.94
At end of follow-up
Hepatic steatosis	1 level more	0.13	0.02-0.89	0.04
Leptin	10 ng/mL more	0.38	0.18-0.81	0.01
Ghrelin	0.1 ng/mL more	1.22	0.74-2.01	0.41
HOMA-IR	1 level more	1.98	0.54-7.30	0.30
Alternatively introduced variables
Fibrosis	1 level more	0.30	0.10-0.93	0.04
Leptin	10 ng/mL more	0.34	0.16-0.72	0.01
Ghrelin	0.1 ng/mL more	1.22	0.74-1.82	0.47
HOMA-IR	1 level more	1.28	0.43-3.79	0.66

CI: Confidence interval; HOMA-IR: Homeostasis model assessment insulin resistance; ORs: Odds ratios.

Table 6 Multiple logistic regression derived odds ratios and 95% CIs for response to hepatitis C virus therapy among patients infected with hepatitis C virus genotype-3 with respect to hepatic steatosis, and leptin and ghrelin concentrations at baseline and at end of follow-up

Variable	Category or increment	ORs	95% CIs	P-value
At baseline
Hepatic steatosis	1 level more	1.04	0.19-5.55	0.97
Leptin	10 ng/mL more	0.64	0.18-2.24	0.49
Ghrelin	0.1 ng/mL more	1.11	0.90-1.49	0.32
HOMA-IR	1 level more	0.13	0.02-0.68	0.02
Alternatively introduced variables
Fibrosis	1 level more	0.16	0.02-0.11	0.06
Leptin	10 ng/mL more	1.22	0.37-4.08	0.74
Ghrelin	0.1 ng/mL more	1.22	0.90-1.65	0.16
HOMA-IR	1 level more	0.16	0.03-0.83	0.03
At end of follow-up
Hepatic steatosis	1 level more	1.77	0.39-7.95	0.46
Leptin	10 ng/mL more	0.40	0.10-1.55	0.18
Ghrelin	0.1 ng/mL more	1.00	0.74-1.22	0.76
HOMA-IR	1 level more	0.10	0.02-0.59	0.01
Alternatively introduced variables
Fibrosis	1 level more	0.40	0.08-1.52	0.16
Leptin	10 ng/mL more	0.70	0.22-2.18	0.54
Ghrelin	0.1 ng/mL more	1.00	0.74-1.35	0.85
HOMA-IR	1 level more	0.14	0.03-0.71	0.02

CI: Confidence interval; HOMA-IR: Homeostasis model assessment insulin resistance; ORs: Odds ratios.