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01-01-2016 | Meta-Analysis

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

Authors: Stergios A. Polyzos, Konstantinos N. Aronis, Jannis Kountouras, Dimitrios D. Raptis, Maria F. Vasiloglou, Christos S. Mantzoros

Published in: Diabetologia | Issue 1/2016

Abstract

Aims/hypothesis

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.

Methods

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).

Results

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.

Conclusions/interpretation

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.

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Title: Circulating leptin in non-alcoholic fatty liver disease: a systematic review and meta-analysis
Authors: Stergios A. Polyzos
Konstantinos N. Aronis
Jannis Kountouras
Dimitrios D. Raptis
Maria F. Vasiloglou
Christos S. Mantzoros
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Diabetologia / Issue 1/2016
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-015-3769-3

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