| Background and aims: Leptin is the product of the obese (ob) gene and it is mainly expressed by the adipose tissue. The discovery of leptin in 1994 represented a tremendous breakthrough in the field of obesity and the regulation of energy balance and food intake. Levels of leptin have been reported to be high in patients who are obese and in individuals with diabetes, as well as in patients with alcoholic liver disease and hepatitis C-induced cirrhosis. Recent studies performed in animal models of liver fibrosis and in models of fatty liver demonstrated that leptin has a pivotal role in the profibrogenic responses in the liver. However, data on leptin and its correlation with the degree of fibrosis in patients with chronic hepatitis B are not reported. As an anti- viral agentjamivudine can reduce inflammatory respond and therefore inhibit the collagen synthesizes in liver, repress the liver injures, decline extracellular matrix accumulation excessively, but its mechanism of improvingliver fibrosis is still unclear. In order to observe the function of leptin in liver fibrogenesis and the relationship between leptin levels and severity of liver fibrosis in chronic hepatitis B, and the effects of lamivudine therapy on leptin expression,we proceeded this clinical research.Methods: 82 consecutive patients with chronic hepatitis B (56 men,26 women, mean age,29.16 ± 8.80 years ) were included. Liver biopsy were performed in all patients in the first 3 days of hospitalisation. The stages of liver fibrosis were divided into 5 stages (stage0-4).The numbers of stage 0-4 patients were 8,24,20,22,8,respectively;gender,age,body mass index of stage 0-4 patients were basic consistence.42 patients of chronic hepatitis B with the evidence of active viral replication and the activity of inflammation were treated with lamivudine (33 men,9 women, mean age: 26.33 ± 7.22 years ).Lamivudine was administrated 100mg once per day for 1 year.Venous blood samples were obtained in all patients in the second day of hospitalisation, serum samples were stored in -80 °C refrigerator until analysis .Serum markers of liver fibrosis, such as hyaluronic acid ( HA), collagen type IV ( CIV), procollagen type III ( PCIII), laminin( LN), were determined by radioimmunoassay(RIA).Serum leptin levels were determined by enzyme-linked immunosorbent assay( ELISA). Result: Serum leptin levels in patients with chronic hepatitis B increasedsignificantly with the severity of liver fibrosis (F=2.629,p=0.041),and they were (4.21 ± 2.96) ng/ml,(4.82 ± 4.48) ng/ml,(6.30 ± 5.96) ng/ml,(7.97 ± 4.52) ng/ml,( 10.08 ± 5.18) ng/ml in liver fibrosis stage0-4 patients respectively. Leptin levels of patients with liver fibrosis stage 4 were significantly higher than those of stage 0,1(p=0.021,0.011, respectively),the levels of leptin in stage 3 patients were also significantly higher than those in stage l(p=0.035).Serum leptin levels of female patients were (8.51 ± 5.35) ng/ml ,significantly higher than those of male patients[(5.25±4.73) ng/ml](t=2.784,p=0.007).In patients with different liver fibrosis degree, serum leptin levels of female with liver fibrosis stage 2 only increased significantly than those male with the same stage (t=3.11 ,p=0.006 ) . Serum leptin levels were positive related with the severity of liver fibrosis, sex and PCIII, its related coefficient is 0.277(p=0.012),0.297(p=0.007),r=0.395(p=0.013), respecti-vely.HA( r=0.518, p=0.001), PCIII( r=0.381, p=0.017), CIV( r=0.324, p=0.046), globulin( r=0.348, p=0.001), GGT( r=0.409, p<0.001l), AST( r=0.326, p=0.003), ALT ( r=0.233, p=0.035) were also positive related with the severity of liver fibrosis ,but serum levels of albumin and(r=-0.457, p<0.001) and prothrombin time activity( r=-0.528, p<0.001) negative related with the severity of liver fibrosis. At the end of 1 year lamivudine treatment ,serum leptin levels of treated patients with chronic hepatitis B significantly decreased from 4.67±6.65 ng/ml to 2.46±3.86 ng/ml (t=2.574, P=0.014), the level of HBVDNA also significantly decrea...
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