Furthermore, patients with chronic liver diseases are usually thin as a result of hypermetabolism, diminished food intake, and malnutrition, and leptin is thought to be involved in this process. Furthermore, other adipocytokines play an important role in lipid metabolism and liver disease progression. Visfatin a 52-kDa protein that has been cloned as pre-B cell colony-enhancing factor (PBEF), and liver and muscle have been reported to be the tissues with the highest expression levels of this protein. Recently, visfatin has also been proposed as an adipokine secreted by adipose tissue.