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Liver fibrosis, a progressive pathological condition, is marked by abnormally high accumulation of extracellular matrix components, ultimately leading to cirrhosis and hepatocellular carcinoma if left unchecked.
Serum leptin, vitamin D, and APRI serve as dynamic non-invasive biomarkers reflecting liver fibrosis severity and recovery following liver transplantation.
Liver fibrosis, a progressive pathological condition, is marked by abnormally high accumulation of extracellular matrix components, ultimately leading to cirrhosis and hepatocellular carcinoma if left unchecked. Although liver biopsy remains the gold standard for fibrosis assessment, its invasive nature has driven increasing reliance on non-invasive biomarkers such as aspartate aminotransferase to platelet count ratio (APRI), fibrosis-4 (FIB-4), leptin, and vitamin D for evaluating disease severity and progression.
Researchers aimed to evaluate the clinical significance of leptin, vitamin D, APRI, and FIB-4 in patients with liver fibrosis before and after liver transplantation and to assess their potential role in disease progression and post-transplant recovery.
This interventional study included 50 people with liver fibrosis who underwent transplantation of liver. Serum leptin and vitamin D levels were measured pre-transplant and at three and six months post-transplant using enzyme-linked immunosorbent assay (ELISA). APRI and FIB-4 scores were examined to check liver fibrosis severity. Qualitative proteomic analysis was performed to identify serum proteins associated with liver fibrosis, including extracellular matrix components. For statistical assessment, one-way ANOVA was employed to compare biomarker levels across time points.
Patients with liver fibrosis demonstrated markedly elevated leptin concentrations and APRI indices compared to controls, with both markers showing a consistent and significant decline following liver transplantation at three and six months. In contrast, vitamin D levels were significantly suppressed at baseline but exhibited a marked postoperative increase.
ROC curve analysis confirmed excellent diagnostic accuracy, with area under the curve values reaching 1.0 for vitamin D and 0.997 for leptin. Integrated proteomic and bioinformatics analyses revealed that the identified protein set was significantly enriched in extracellular matrix organization, immune modulation, and fibrosis-related pathways. The Search Tool for the Retrieval of Interacting Genes (STRING) network mapping further demonstrated a tightly interconnected protein interaction network involving leptin and vitamin D, highlighting their potential regulatory role in extracellular matrix remodeling and liver fibrosis pathophysiology.
Serum vitamin D and leptin proved to be highly accurate, non-invasive biomarkers for liver fibrosis, with strong diagnostic and prognostic potential. When combined with APRI and FIB-4 scores, these markers offer a powerful approach for early detection, disease monitoring, and post-transplant evaluation in chronic liver disease and cirrhosis.
BMC Gastroenterology
Leptin, vitamin D, and APRI values during the six months post-liver transplantation
Yasmine A. Algobashy et al.
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