No influence of surgical stress on postoperative leptin gene expression in different adipose tissues and soluble leptin receptor plasma levels.
As part of the postsurgical stress response, plasma leptin levels increase in-between 12 h postoperatively.


OBJECTIVE
To study the kinetics of leptin gene expression in different adipose tissues before and after severe surgical trauma in children and adults.


METHODS
In 22 adults and 23 children with cardiac and 19 adult patients with abdominal surgery, we measured plasma leptin concentrations preoperatively, 4 and 10-17 h postoperatively and quantified leptin mRNA expression by TaqMan real-time PCR in adipose tissue taken at the beginning and the end of surgery from subcutaneous, intrathoracic, omental and mesenteric fat. Plasma-soluble leptin receptor levels were measured in 23 children after cardiosurgery.


RESULTS
Plasma leptin levels doubled between 4 and 10-17 h postoperatively in adults (p < 0.001) as well as in children (p = 0.0002) with cardiac surgery. After abdominal surgery, 10-17 h postoperatively, plasma leptin concentrations increased significantly (p < 0.05). During the operation, leptin gene expression did not change in neither of the patient groups. Plasma-soluble leptin receptor levels decreased immediately after the onset of surgery and remained unchanged thereafter.


CONCLUSIONS
Leptin gene expression is not up-regulated during surgery. The measured increase in plasma leptin after surgery does not result from elevated levels of soluble leptin receptor but may follow an up-regulation of leptin gene expression later after the operation due to postsurgical metabolic changes.
Schoof
Ellen
E
Klinik für Kinder und Jugendliche, Klinische Chemie und Molekulare Diagnostik, Universität Leipzig, Deutschland.
Stuppy
Anja
A
Harig
Frank
F
Singer
Helmut
H
Carbon
Roman
R
Horbach
Thomas
T
Kratzsch
Jürgen
J
Rascher
Wolfgang
W
Dötsch
Jörg
J
D000005:Abdomen / Q000601:surgery*; D000273:Adipose Tissue / Q000201:enzymology / Q000378:metabolism*; D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015870:Gene Expression; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases / Q000235:genetics; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011184:Postoperative Period; D012333:RNA, Messenger / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000097:blood / Q000737:chemistry / Q000145:classification* / Q000235:genetics*; D054411:Receptors, Leptin; D012995:Solubility; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013997:Time Factors
C515448:LEPR protein, human; D012333:RNA, Messenger; D011956:Receptors, Cell Surface; D054411:Receptors, Leptin; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases