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In contrast, elevated serum leptin levels in alcoholic cirrhosis demonstrate a positive correlation with the severity of hepatic pathology [225]

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Although the exact mechanism is unknown, this rise in melanocyte activity has been shown to be stimulated by prostanoids, cytokines, chemokines, and other inflammatory mediators as well as reactive oxygen species that are released during the inflammatory process

However, when an individual has an ongoing systemic inflammatory state, these anti-oxidant proteins can be dissociated from the HDL or become inactivated resulting in the increased generation of oxidized and peroxidized lipids which are proatherogenic