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Exp Clin Endocrinol Diabetes 2003; 111(7): 435-442
DOI: 10.1055/s-2003-44291
Article

J. A. Barth Verlag in Georg Thieme Verlag Stuttgart · New York

TIPS Implantation Raises Leptin Levels in Patients with Liver Cirrhosis

W. Nolte 1 [*] , M. Wirtz 1 [*] , C. Rossbach 1 , U. Leonhardt 1 , A. B. Buchwald 2 , K.-H. Scholz 2 , G. Ramadori 1
  • 1The Department of Medicine, Division of Gastroenterology and Endocrinology, Georg-August-University, Göttingen, Germany
  • 2The Department of Medicine, Division of Cardiology and Pulmonology, Georg-August-University, Göttingen, Germany
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Publication History

Received: September 26, 2002 First decision: November 24, 2002

Accepted: March 3, 2003

Publication Date:
13 November 2003 (online)

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Abstract

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.

Key words

Liver cirrhosis - TIPS - BMI - leptin - malnutrition

References

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1 The first two authors contributed equally to this paper.

M. D. M. Wirtz

Chirurgische Universitätsklinik
Abteilung für Allgemein-, Viszeral- und Unfallchirurgie

Im Neuenheimer Feld 110

69120 Heidelberg

Germany

Phone: + 49 6221 56 3622

Fax: + 49 6221 56 6903

Email: martin_wirtz@med.uni-heidelberg.de

M. D. W. Nolte

Medizinische Universitätsklinik
Abteilung für Gastroenterologie und Endokrinologie

Robert-Koch-Straße 40

37075 Göttingen

Germany

Phone: + 49 5513 96326

Fax: + 49 5513 919125

Email: wil.nolte@med.uni-goettingen.de

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