Association of serum leptin and ghrelin levels with smoking status on body weight: a systematic review and meta-analysis
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Background and aims: Smoking cigarettes is a major global health problem that affects appetite and weight. The aim of this systematic review was to determine how smoking affected plasma leptin and ghrelin levels. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and Ovid was conducted using a well-established methodology to gather all related publications. Results: A total of 40 studies were included in the analysis of 11,336 patients. The overall effect showed a with a mean difference (MD) of −1.92[95%CI; −2.63: −1.20] and p = 0.00001. Subgroup analysis by study design revealed significant differences as well, but with high heterogeneity within the subgroups (I2 of 82.3%). Subgroup by sex showed that there was a significant difference in mean difference between the smoking and non-smoking groups for males (MD = −5.75[95% CI; −8.73: −2.77], p = 0.0002) but not for females (MD = −3.04[95% CI; −6.6:0.54], p = 0.10). Healthy, pregnant, diabetic and CVD subgroups found significant differences in the healthy (MD = −1.74[95% CI; −03.13: −0.35], p = 0.01) and diabetic (MD = −7.69[95% CI, −1.64: −0.73], p = 0.03). subgroups, but not in the pregnant or cardiovascular disease subgroups. On the other hand, the meta-analysis found no statistically significant difference in Ghrelin serum concentration between smokers and non-smokers (MD = 0.52[95% CI, −0.60:1.63], p = 0.36) and observed heterogeneity in the studies (I2 = 68%). Conclusion: This study demonstrates a correlation between smoking and serum leptin/ghrelin levels, which explains smoking’s effect on body weight. Systematic review registration: https://www.crd.york.ac.uk/ prospero/display_record.php, identifier (Record ID=326680).
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Smoking raises leptin levels, while cessation lowers them, though reverse is also true in few other studies.
“It has been shown in previous studies that smoking raises leptin levels, while cessation of smoking lower the levels, whereas, the reverse is also true in few other studies [13].”
From Smoking and its impact on eating behavior: A review (2026) · cites this paper as [13]
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The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
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Cigarette Smoking, Nicotine, and Body Weight
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Cited by
Sorted by citations
Smoking and its impact on eating behavior: A review
Department of Oral Pathology and Microbiology, M. A. D. C. A. H., Prabhakar, M., Bottu, K., Department of Oral Pathology and Microbiology, M. A. D. C. A. H., Chaly, P. E., Department of Public Health Dentistry, M. A. D. C. A. H., S.G, R. K., Department of Public Health Dentistry, T. G. D. C. A. H., M, A., & Department of Psychiatry, M. M. C. H. A. R. I. (2026) · Bioinformation · doi:10.6026/973206300220132
- Authors
- Shaheen, N., Shaheen, A., Diab, R. A., Saad, A. M., Abdelwahab, O. A., Soliman, S., Hefnawy, M. T., Ramadan, A., Meshref, M., & Nashwan, A. J.
- Affiliations
- Alexandria University (EG)
- Al-Azhar University (EG)
- First Pavlov State Medical University of St. Petersburg (RU)
- Zagazig University (EG)
- South Valley University (EG)
- Hamad Medical Corporation (QA)
- Corresponding author
- Nashwan, Abdulqadir J.
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2023-12-04
- Volume
- 14
- Pages
- 1296764-1296764
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC10725976
- OpenAlex
- W4389326699
- Cited by
- 7
- References
- 6
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2
- FWCI
- 0.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Qatar National Library
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- smoking, leptin, ghrelin, body weight, appetite, serum hormone levels, sex differences, diabetes mellitus, pregnancy, cardiovascular disease
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