Diagnostic and Prognostic Value of Serum Leptin in Sepsis

Document Type : Original Article

Authors

1 Critical care department, Faculty of Medicine, Beni Suef University, Egypt.

2 Critical care department, Faculty of Medicine, Cairo University, Egypt.

Abstract

Background: One of the biggest global health issues and the main cause of intensive care unit (ICU) admissions is sepsis. Biomarkers can have a very vital role in sepsis diagnosis. The 16 kDa, 167-amino acid peptide leptin is mainly produced by adipocytes and has a role in controlling energy balance by telling the brain adipose tissue volume  in the body, which in turn controls how much food is consumed and how much energy is used. Leptin is also a cytokine that is involved in cytokine crosstalk and cell-mediated immunity. According to earlier researchs, sepsis patients' leptin level is elevated when compared to controls. Objective: Our study aimed to test the validity of serum leptin as a biomarker for sepsis diagnosis and to correlate between the level of leptin and sepsis prognosis and mortality. Methods: Twenty five critically ill patients diagnosed with sepsis were included in our study, ten healthy volunteers as a control group. The patients were admitted to the critical care department in Beni-Suef university hospital in the period from October 2023 to February 2024.Serum samples were collected from the studied patients on admission day (day 0), 2nd day of admission (day 2) and 5th day of admission (day 5), and only once in control group to correlate between leptin levels in patients and control group and to find the correlation between leptin and mortality. Results: Our study showed that leptin levels showed strong positive correlation with body mass index (BMI). No significant correlation was found between leptin in the studied group and control group on admission (day 0) while there was a highly significant correlation on day 2 and day 5. There was no significant difference in leptin levels between sepsis and septic shock patient on day 0, day 2 and day 5. There was a weak linear relation between leptin level with APACHE II & SOFA scores. There was non-significant difference in leptin level between survivors and non-survivors on day 0, 2 and 5. Conclusion: From our study we could suggest that leptin level in serum can be used as a good diagnostic marker in sepsis but not a good prognostic one.

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References

  1. Nedeva, C., Menassa, J., & Puthalakath, H. (2019). Sepsis: inflammation is a necessary evil. Frontiers in cell and developmental biology, 7, 108.‏
  2. Banta, J. E., Joshi, K. P., Beeson, L., et al. (2012). Patient and hospital characteristics associated with inpatient severe sepsis mortality in California, 2005–2010. Critical care medicine, 40(11), 2960-2966.‏
  3. Cohen, M., & Banerjee, D. (2023). Biomarkers in Sepsis: A Current Review of New Technologies. Journal of Intensive Care Medicine, 08850666231194535.‏
  4. Pérez-Pérez, A., Sánchez-Jiménez, F., Vilariño-García, T., & Sánchez-Margalet, V. (2020). Role of leptin in inflammation and vice versa. International journal of molecular sciences, 21(16), 5887.‏
  5. Mackey-Lawrence, N. M., & Petri, W. A. (2012). Leptin and mucosal immunity. Mucosal immunology, 5(5), 472-479.‏
  6. La Cava, A. (2017). Leptin in inflammation and autoimmunity. Cytokine, 98, 51-58.‏
  7. Iikuni, N., Kwan Lam, Q. L., Lu, L., Matarese, G., & Cava, A. L. (2008). Leptin and inflammation. Current immunology reviews, 4(2), 70-79.‏
  8. Yousef, A. A. A. M., Amr, Y. M., & Suliman, G. A. (2010). The diagnostic value of serum leptin monitoring and its correlation with tumor necrosis factor-α in critically ill patients: a prospective observational study. Critical Care, 14(2), R33.‏
  9. Singer, M., Deutschman, C. S., Seymour, C. W., et al. (2016). The third international consensus definitions for sepsis and septic shock (sepsis-3). Jama, 315(8), 801-810.‏
  10. Chen, M., Wang, B., Xu, Y., et al. (2014). Diagnostic value of serum leptin and a promising novel diagnostic model for sepsis. Experimental and therapeutic medicine, 7(4), 881-886.
  11. Carlson, G. L., Saeed, M., Little, R. A., et al. (1999). Serum leptin concentrations and their relation to metabolic abnormalities in human sepsis. American Journal of Physiology-Endocrinology And Metabolism, 276(4), E658-E662.‏
  12. Hillenbrand, A., Knippschild, U., Weiss, M., Schrezenmeier, H., et al. (2010). Sepsis induced changes of adipokines and cytokines-septic patients compared to morbidly obese patients. BMC surgery, 10(1), 26.‏
  13. Farag, N. A., Taema, K. M., Abdel-Latiff, E., et al. (2013). Differentiating sepsis from non-infective systemic inflammatory response syndrome: comparison between C-reactive protein and leptin. The Egyptian Journal of Critical Care Medicine, 1(3), 111-118.‏
  14. Koch, A., Weiskirchen, R., Zimmermann, H. W., et al. (2010). Relevance of serum leptin and leptin-receptor concentrations in critically ill patients. Mediators of inflammation, 2010.‏
  15. Papathanassoglou, E. D., Moynihan, J. A., Ackerman, M. H., et al. (2001). Serum leptin levels are higher but are not independently associated with severity or mortality in the multiple organ dysfunction/systemic inflammatory response syndrome: a matched case control and a longitudinal study. Clinical endocrinology, 54(2), 225-233.‏
  16. Quasim, T., McMillan, D. C., Wallace, A. M., et al. (2004). The relationship between leptin concentrations, the systemic inflammatory response and illness severity in surgical patients admitted to ITU. Clinical Nutrition, 23(2), 233-238.‏
  17. Pehlivanli, F., Ağalar, F., Ağalar, C., et al. (2011). The value of CRP, IL-6, leptin, cortisol, and peritoneal caspase-3 monitoring in the operative strategy of secondary peritonitis. Ulus travma acil cerrahi Derg, 17(5), 390-395.
  18. Behnes, M., Brueckmann, M., Lang, S., et al. (2012). Alterations of leptin in the course of inflammation and severe sepsis. BMC infectious diseases, 12(1), 217.‏
  19. Hillenbrand, A., Xu, P., Zhou, S., et al. (2016). Circulating adipokine levels and prognostic value in septic patients. Journal of Inflammation, 13(1), 30.‏
  20. Ahasic, A. M., & Pisani, M. (2016). Adipokines Early In Critical Illness. In A104. CRITICAL CARE: SEPSIS TRANSLATIONAL INSIGHTS (pp. A2730-A2730). American Thoracic Society.‏
  21. Tzanela, M., Orfanos, S. E., Tsirantonaki, M., et al. (2006). Leptin alterations in the course of sepsis in humans. In Vivo, 20(4), 565-570.‏
  22. Cesur, S., Şengül, A., Kurtoğlu, Y., et al. (2011). Prognostic value of cytokines (TNF-α, IL-10, Leptin) and C-reactive protein serum levels in adult patients with nosocomial sepsis. Journal of Microbiology and Infectious Diseases, 1(03).‏
  23. Bracho-Riquelme, R. L., Reyes-Romero, M. A., Pescador, N., et al. (2008). A leptin serum concentration less than 10 ng/ml is a predictive marker of outcome in patients with moderate to severe secondary peritonitis. European Surgical Research, 41(2), 238-244.

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