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Aims: While the gold standard in the assessment of liver\u00a0fibrosis\u00a0remains\u00a0liver biopsy, non-invasive methods have been increasingly used for estimating liver fibrosis. This study aims at contributing to our understanding of the role of leptin,vitamin D, APRI, and FIB-4 in the progression of liver disease. For this purpose, we evaluate the clinical significance of leptin, vitamin D, APRI, and FIB-4 in cirrhotic patients with different ratios of steatosis and in cirrhotic pateints with different grades of hepatocellular carcinoma. We compare the performance of simple biochemical scores (FIB-4 and APRI) with leptin and vitamin D. Also, We identified the\u00a0proteins in the serum of liver fibrosis and showed the role of these proteins in the pathogenesis of liver fibrosis. Also, we identified the relationship between leptin and vitamin D with extracellular matrix proteins using bioinformatics analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\u00a0The current study included 50 liver fibrosis patients who underwent liver transplantation. We measured the levels of serum vitamin D and leptin in these patients at pre-LT and three- and six-months post-LT using\u00a0enzyme-linked immunosorbent assay.\u00a0We performed qualitative proteomic analysis to identify\u00a0the proteins in the sera from patients with liver fibrosis. Among these proteins, there are extracellular matrix proteins. One-way\u00a0ANOVA\u00a0test was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found that serum leptin levels and APRI values were significantly higher in liver fibrosis patients than in controls, after three- and six-months following\u00a0LT serum leptin levels\u00a0and APRI values significantly decreased. While serum vitamin D levels were significantly lower in liver fibrosis patients than in controls, after three- and six-months following LT, serum vitamin D levels significantly increased. ROC curves analysis showed that the area under the curve (AUC) of vitamin D and leptin was 1 and 0.997, respectively. Gene ontology analysis demonstrated that the proteins participate in a diverse array of biological processes, emphasizing the systemic effects of liver fibrosis disease. From the STRING database, the proteins are at least partially biologically connected, as a group with leptin and vitamin D explaining the promiscuous nature of leptin and vitamin D. This emphasized the role of leptin and vitamin D in accumulation and increased synthesis of extracellular matrix proteins that incorporated in the pathogenesis of liver fibrosis, and showed that the leptin and vitamin D are involved in the pathogenesis process where the total proteins are involved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\u00a0In summary, serum vitamin D and leptin\u00a0could serve as a valuable supplemental biomarker for predicting the liver fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-026-04640-9","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T05:18:52Z","timestamp":1771564732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Leptin, vitamin D, and APRI values during the six months post-liver transplantation"],"prefix":"10.1186","volume":"26","author":[{"given":"Yasmine A.","family":"Algobashy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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