Circulating leptin levels after cardiopulmonary bypass in children.
OBJECTIVE
To characterize the dynamics of circulating leptin in children after cardiac surgery with cardiopulmonary bypass (CPB), which is known to induce a systemic inflammatory response.


METHODS
Investigative study.


METHODS
University-affiliated tertiary care hospital.


METHODS
Eight children (age range, 3 months to 13 years) undergoing CPB to correct congenital heart disease.


METHODS
The time courses of leptin and cortisol levels were determined. Serial blood samples were collected from the arterial catheter or from the CPB circuit preoperatively; on termination of CPB; and at 2, 4, 8, 12, 18, and 24 hours postoperatively. Plasma was recovered immediately, divided into aliquots, and frozen at -70 degrees C until use. Leptin was measured by a human leptin radioimmunoassay kit.


RESULTS
Leptin levels during CPB decreased to 50% of pre-CPB levels (p < 0.01). After termination of CPB, levels increased gradually and peaked at 12 hours postoperatively (10 P.M. to 1 A.M.). Cortisol levels were inversely correlated to leptin levels (p = 0.016).


CONCLUSIONS
CPB is associated with acute changes in circulating leptin levels. These changes parallel those in cortisol, showing an inverse relationship between leptin and cortisol, suggesting a relationship between the neurobiology of these systems that could be important for the neuroendocrine response to CPB. A prognostic role of leptin and its relationship to cortisol after CPB warrant further study.
Modan-Moses
D
D
Department of Pediatric Intensive Care, The Chaim Sheba and Schneider Medical Centers, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Kanety
H
H
Dagan
O
O
Pariente
C
C
Ben-Abraham
R
R
Freedman
L
L
Prince
T
T
Shimon
I
I
Barzilay
Z
Z
Paret
G
G
D000293:Adolescent; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007223:Infant; D020738:Leptin / Q000097:blood*
D020738:Leptin; D006854:Hydrocortisone