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. 2002 Sep;51(3):434-9.
doi: 10.1136/gut.51.3.434.

Fatigue is associated with high circulating leptin levels in chronic hepatitis C

T Piche  1 , E Gelsi, S M Schneider, X Hébuterne, J Giudicelli, B Ferrua, C Laffont, S Benzaken, P Hastier, M L Montoya, F Longo, P Rampal, A Tran
Affiliations

Fatigue is associated with high circulating leptin levels in chronic hepatitis C

T Piche et al. Gut. 2002 Sep.

Abstract

Background and aims: Fatigue is a frequent and disabling symptom reported by patients with chronic hepatitis C (CHC). Its mechanism is poorly understood. Recent attention has focused on the role of leptin and energy expenditure in CHC. Our aims were to analyse fatigue in CHC and to determine its relationship with disease activity, resting energy expenditure (REE), circulating leptin, and tumour necrosis factor alpha (TNF-alpha).

Methods: Seventy eight CHC patients, 22 healthy controls, and 13 primary biliary cirrhosis (PBC) patients underwent measurements of REE, body composition, leptin, and TNF-alpha. All subjects completed the fatigue impact scale (FIS) questionnaire. A liver biopsy and viral load measurements were performed in all patients.

Results: Thirty eight of 78 CHC patients considered fatigue the worst or initial symptom of their disease. The fatigue score of patients was significantly higher than that of controls (53.2 (40.1) v 17.7 (16.9); p<0.0001) and was more pronounced in females (p=0.003). Leptin was increased significantly in CHC patients compared with controls (15.4 (20.7) v 6.4 (4.1) ng/ml; p<0.05). In CHC patients, the fatigue score correlated significantly with leptin corrected for fat mass (r=0.30, p=0.01). This correlation increased when the physical domain of fatigue was included (r=0.39, p=0.0009). Furthermore, a similar positive correlation was found in PBC patients (r=0.56, p=0.04). No correlation was found between fatigue and age, REE, liver function tests, viral load, or the METAVIR score in CHC patients.

Conclusions: Fatigue is present in CHC patients and is more pronounced in females. The FIS questionnaire is clinically relevant and may be useful for future therapeutic trials aimed at reducing fatigue. Fatigue may be partly mediated by leptin.

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Figures

Figure 1
Figure 1
Fatigue in chronic hepatitis C (CHC). TS, total score; CS, cognitive score; PS, physical score; PsS, psychosocial score. (A) Comparison between female patients and controls. (B) Comparison between male patients and controls. *p<0.05, **p<0.01.
Figure 2
Figure 2
Absolute leptin levels (A) and leptin levels corrected for fat mass (FM) (B) in female and male patients with chronic hepatitis C (CHC) and controls.
Figure 3
Figure 3
Comparison of serum tumour necrosis factor α (TNF-α) levels in male and female patients with chronic hepatitis C (CHC) and controls. *p=0.03.
Figure 4
Figure 4
Relationship between leptin and fatigue in chronic hepatitis C patients. Correlation between absolute leptin levels and total score of fatigue (A) and its physical domain (B). Correlation between leptin levels corrected for fat mass and the total score of fatigue (C) and its physical domain (D).
Figure 5
Figure 5
Correlation between leptin levels corrected for fat mass and the total score of fatigue in primary biliary cirrhosis patients.
See this image and copyright information in PMC

Comment in

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