LEPR and fatty liver disease: Level 3 confirmation. The action of leptin is mediated by the leptin receptor, a membrane bound receptor which can be cleaved from the membrane and detected in circulation (van Dielen et al., 2002). Leptin and soluble leptin receptor are independently and inversely associated with gestational diabetes (Mosavat et al., 2018). Soluble leptin levels are associated with pancreatic beta-cell dysfunction in T2DM patients (Morioka et al., 2018). Hepatic steatosis is negatively correlated with soluble Leptin receptor (Cernea et al., 2018).