The relationship between leptin concentrations, the systemic inflammatory response and illness severity in surgical patients admitted to ITU.
OBJECTIVE
The relationship between circulation leptin concentrations, mediators of the systemic inflammatory response and illness severity in critically ill patients remains unclear. The aim of the present study was to examine these relationships in critically ill surgical patients admitted to the intensive therapy unit (ITU).


METHODS
Patients (n = 38) who had undergone surgery and subsequently admitted to ITU were prospectively entered into a cross-sectional study. Circulating concentrations of leptin, cortisol, growth hormone, interleukin-6, C-reactive protein and albumin were measured. Sex and age matched controls (n = 14) were also studied.


RESULTS
On day 1, the critically ill group had lower BMI and leptin concentrations and a pronounced systemic inflammatory response compared with controls. There was a weak positive correlation between leptin concentrations and BMI in the critically ill patients (r = 0.42, P<0.10). In contrast, leptin was inversely correlated with C-reactive protein (r = -0.59, P<0.05) but not with cortisol, growth hormone, interleukin-6, APACHE II or predicted mortality. Leptin concentrations did not alter with the day of admission to ITU.


CONCLUSIONS
On ITU admission, leptin concentrations appeared to be low for BMI, related to the magnitude of the systemic inflammatory response but did not appear to be regulated by proposed mediators in critically ill surgical patients.
Quasim
Tara
T
University Department of Surgery, Glasgow Royal Infirmary, Glasgow G31 2ER, Scotland, UK.
McMillan
Donald C
DC
Wallace
A Michael
AM
Kinsella
John
J
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016638:Critical Illness; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007362:Intensive Care Units; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012121:Respiration, Artificial; D012720:Severity of Illness Index
D020738:Leptin