Sepsis is a life-threatening condition and obesity is related to the clinical outcome. The underlying reasons are incompletely understood, but the adipocyte derived hormones leptin and adiponectin may be involved.
Patients aged 18 years or more with documented first time sepsis events were included in a nested case-referent study if they had participated in previous health surveys. Two matched referents free of known sepsis were identified. Circulating levels of leptin and adiponectin were determined in stored plasma, and their impact on a future sepsis event and its outcome was evaluated.
We identified 152 patients (62% women) with a sepsis event and a previous participation in a health survey. Eighty-three % had also blood samples from the acute event. Hyperleptinemia at health survey associated with a future sepsis event (OR 1.77, 95% CI 1.04–3.00) and with hospital death. After adjustment for BMI leptin remained associated with sepsis in men, but not in women. High levels in the acute phase associated with increased risk for in hospital death in women (OR 4.18, 95% CI 1.17–15.00), while being protective in men (OR 0.05, 95% CI 0.01–0.48). Furthermore, leptin increased more from baseline to the acute phase in men than in women. Adiponectin did not predict sepsis and did not relate to outcome.
Hyperleptinemia independently predicted the development of sepsis and an unfavourable outcome in men, and inertia in the acute response related to worse outcome.
Maurizi G, Della Guardia L, Maurizi A, Poloni A. Adipocytes properties and crosstalk with immune system in obesity-related inflammation. J Cell Physiol. 2017;
Vassiliadi DA, Tzanela M, Kotanidou A, Orfanos SE, Nikitas N, Armaganidis A, Koutsilieris M, Roussos C, Tsagarakis S, Dimopoulou I. Serial changes in adiponectin and resistin in critically ill patients with sepsis: associations with sepsis phase, severity, and circulating cytokine levels. J Crit Care. 2012;27:400–9. CrossRefPubMed
Koch A, Weiskirchen R, Zimmermann HW, Sanson E, Trautwein C, Tacke F. Relevance of serum leptin and leptin-receptor concentrations in critically ill patients. Mediat Inflamm. 2010;2010
Papathanassoglou ED, Moynihan JA, Ackerman MH, Mantzoros CS. 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. Clin Endocrinol. 2001;54:225–33. CrossRef
Grigoras I, Branisteanu DD, Ungureanu D, Rusu D, Ristescu I. Early dynamics of leptin plasma level in surgical critically ill patients. A prospective comparative study. Chirurgia (Bucur). 2014;109:66–72.
Hillenbrand A, Xu P, Zhou S, Blatz A, Weiss M, Hafner S, Henne-Bruns D, Knippschild U. Circulating adipokine levels and prognostic value in septic patients. J Inflamm (Lond). 2016;13:30. CrossRef
Norberg M, Wall S, Boman K, Weinehall L. The Vasterbotten intervention Programme: background, design and implications. Glob Health Action. 2010;3
Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM consensus conference committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101:1644–55. CrossRefPubMed
Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG. The SOFA (sepsis-related organ failure assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–10. CrossRefPubMed
Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia. Report of a WHO/IDF consultation: World Health Organization; 2006.
Maruna P, Gurlich R, Frasko R, Haluzik M. Serum leptin levels in septic men correlate well with C-reactive protein (CRP) and TNF-alpha but not with BMI. Physiol Res. 2001;50:589–94. PubMed
Lilja M, Rolandsson O, Shaw JE, Pauvaday V, Cameron AJ, Tuomilehto J, Alberti KG, Zimmet PZ, Soderberg S. Higher leptin levels in Asian Indians than creoles and Europids: a potential explanation for increased metabolic risk. Int J Obes. 2010;34:878–85. CrossRef
Ma Z, Gingerich RL, Santiago JV, Klein S, Smith CH, Landt M. Radioimmunoassay of leptin in human plasma. Clin Chem. 1996;42:942–6. PubMed
- Leptin independently predicts development of sepsis and its outcome
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II