Ghrelin/leptin-imbalance in patients with primary biliary cirrhosis

Background: The recently discovered peptide hormone ghrelin mainly produced in gastric oxyntic cells may act as a counterpart to leptin in the regulation of food intake and fat utilization. Leptin, involved in the stimulation of proinflammatory cytokines and catabolic energy balance, is elevated in patients with liver cirrhosis. In the present study, we evaluated serum ghrelin and bound leptin levels in patients with primary biliary cirrhosis (PBC) in relation to C-peptide and glucose concentration. Methods: In 22 female patients with PBC (Child-Pugh stage A) and in 36 female controls we measured serum ghrelin, bound leptin, and C-peptide levels using specific immunoassays. Results: In comparison to controls serum bound leptin levels were significantly higher in patients with PBC (p<0.01) whereas serum ghrelin levels were decreased compared to the control group (p<0.01). In parallel, C-peptide concentrations, were increased (p<0.01) with no significant change in circulating glucose levels. Conclusion: Our data confirm in PBC patients that serum bound leptin levels are increased and clearly show a parallel decrease in serum ghrelin concentrations acting as a physiological counterpart to leptin. Furthermore, we suggest that these changes are linked to the insulin resistance observed in our patients.