Influence of leptin levels and body weight in survival of children with sepsis.
High levels of serum leptin (LPT) were reported in adult patients with sepsis and a protective role was suggested. LPT was determined in sera from 55 children with severe sepsis at admission (0 h), 6, 24 and 48 h. LPT levels were higher at 0 h than at 24 h (2.80 vs 1.61 ng/ml; p = 0.009) and a negative correlation was found with IL-13 (p = 0.009), and granulocyte counts (p = 0.035), but not with other factors. Infants younger than 12 mo of age had higher LPT levels than older infants (5.88 vs 2.38 ng/ml; p = 0.0005). The increase in LPT levels was higher in non-survivor patients than in survivors, with a maximum difference at 24 h (5.30 vs 1.45 ng/ml; p = 0.0042). However, LPT levels were not associated with shock, multiorgan failure or the severity score. Children who died showed higher percentiles of weight than survivors (p = 0.025). A subgroup with higher LPT (> Pc75) included mainly patients with weight > Pc50 (p = 0.0065), low IL-13 levels (p = 0.007) and low granulocyte counts (p = 0.013), Neisseria meningitidis B being the most frequently isolated germ (p = 0.022).


CONCLUSIONS
Using a model of severe infection, mainly meningococcal, in young children (median 3 y 6 mo old), it was not possible to confirm previous results in adults. A general protective role for LPT in sepsis seems unlikely.
Blanco-Quirós
A
A
Department of Paediatrics, University of Valladolid, Spain. ablanco@ped.uva.es
Casado-Flores
J
J
Arranz
E
E
Garrote
J A
JA
Asensio
J
J
Pérez
A
A
D000293:Adolescent; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D020738:Leptin / Q000096:biosynthesis* / Q000097:blood*; D008297:Male; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016019:Survival Analysis
D015415:Biomarkers; D020738:Leptin