Serum Leptin
Levels in Septic Men Correlate Well with
C-Reactive Protein (CRP) and TNF-alpha but not
with BMI
P.
MARUNA1, 2, R. GÜRLICH3,
R. FRAŠKO3, M. HALUZÍK2
1Institute of
Pathological Physiology, 2Third
Internal Department and 3First
Department of Surgery, First Faculty of Medicine,
Charles University, Prague, Czech Republic
Received
January 18, 2001
Accepted April 4, 2001
Summary
Leptin,
an adipocyte-derived signaling factor, is a
member of the IL-6 cytokine family. However there
is no direct evidence of leptin stimulation of
the acute phase protein (APP) synthesis which is
typical for all other IL-6-like factors. The
purpose of this study was to characterize the
dynamics of circulating leptin in relation to ten
APPs. We used postoperative septic patients as a
model of cytokine network hyperstimulation and
intensive APP reaction. The prospective study was
performed on 22 patients with proven
postoperative intraabdominal sepsis after large
abdominal surgery. Plasma levels of leptin,
TNF-a, IL-1ß, soluble IL-2 receptor (sIL-2R),
IL-6 (ELISA analysis) and ten APPs (nephelometric
analysis) were estimated. We have demonstrated a
statistically significant elevation of plasma
leptin concentrations in the septic group
compared with healthy subjects (p<0.001). The
correlation of plasma leptin and BMI during
postoperative sepsis was diminished. The
regression coefficient was the highest for leptin
and CRP (r=0.48, p<0.05), and for leptin and
alpha-1-antitrypsin (r=0.46, p<0.05) in the
septic group. There was significant correlation
between TNF-a and leptin (r=0.47, p<0.05) and
between IL-6 and leptin (r=0.45, p<0.05) in
septic patients. No significant correlation was
found between leptin and "negative" APP
and between leptin and IL-1ß. Leptin has thus
been shown as an acute phase reactant with a
potential hematopoietic, immunomodulatory and
hepatocyte stimulating activity during the
infectious and non-infectious stress response.
The significant correlation between leptin and
CRP and leptin and alpha-1-antitrypsin indicates
that leptin can participate in APP synthesis
regulation during a systemic inflammatory
response.
Key words
C
reactive protein · Inflammation · Leptin ·
Tumor necrosis factor
Reprint
requests
P.
Maruna, M.D., Ph.D., Third Internal Department,
First Faculty of Medicine, U nemocnice 1, 120 00
Prague 2, Czech Republic. Fax: ++ 420 2 2491
9780. E-mail: maruna@lf1.cuni.cz
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