Inverse relationship between circulating levels of leptin and bone mineral density in chronic liver disease


Dr S Ormarsdóttir, Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden. Email:


Background and Aim: The pathophysiology of osteoporosis complicating chronic liver disease is unknown. Recent animal studies have found leptin to be a potent inhibitor of bone formation. The aim of this study was to investigate the relationship between serum leptin levels and bone mineral density in patients with chronic liver disease.

Methods: Fifty-eight patients, 39 females and 19 males, and age- and gender-matched controls were included. Bone mineral density was measured by using dual energy X-ray absorptiometry. Serum leptin was measured by using a radioimmunoassay.

Results: The mean serum leptin concentration was 10.4 ± 11.3 and 15.2 ± 17.9 ng/mL; P = 0.11, in the patients and controls, respectively. Leptin correlated positively with body mass index in patients (r = 0.40; P = 0.003) and in controls (r = 0.55; P < 0.0001). In patients classified as Child–Pugh grade B and C, serum leptin correlated negatively with bone mineral density in females at both the lumbar spine and the femoral neck (r = –0.78; P = 0.04 and r = –0.86; P = 0.03, respectively). In male patients, the correlation was only significant at the lumbar spine (r = –0.99; P = 0.002 and r = –0.86; P = 0.06, at the lumbar spine and femoral neck, respectively). No correlation was found between serum leptin and bone mineral density in the controls.

Conclusion: An inverse relationship between serum leptin and bone mineral density was found in patients with advanced chronic liver disease. The reasons for these findings are uncertain, but a pathophysiological role of circulating leptin in osteoporosis in chronic liver disease is possible.