Article Text

Download PDFPDF
Fatigue is associated with high circulating leptin levels in chronic hepatitis C
  1. T Piche1,
  2. E Gelsi1,
  3. S M Schneider1,
  4. X Hébuterne1,
  5. J Giudicelli2,
  6. B Ferrua2,
  7. C Laffont3,
  8. S Benzaken4,
  9. P Hastier1,
  10. M L Montoya1,
  11. F Longo1,
  12. P Rampal1,
  13. A Tran1
  1. 1Department of Hepatogastroenterology and Nutrition, CHU de NICE, France
  2. 2Department of Biochemistry, CHU de NICE, France
  3. 3Department of Virology, CHU de NICE, France
  4. 4Department of Immunology, CHU de NICE, France
  1. Correspondence to:
    Dr T Piche, Hôpital de l'Archet 2, HépatoGastroenterologie et Nutrition, BP 3079, 06202 NICE Cedex 3, France;


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 α (TNF-α).

Methods: Seventy eight CHC patients, 22 healthy controls, and 13 primary biliary cirrhosis (PBC) patients underwent measurements of REE, body composition, leptin, and TNF-α. 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.

  • fatigue
  • chronic hepatitis C
  • leptin
  • CHC, chronic hepatitis C
  • FIS, fatigue impact scale
  • REE, resting energy expenditure
  • FM, fat mass
  • FFM, fat free mass
  • TNF-α, tumour necrosis factor α
  • ALT, alanine aminotransferase
  • BMI, body mass index
  • HCV, hepatitis C virus
  • PBC, primary biliary cirrhosis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


Linked Articles

  • Ian Forgacs