title: Effects of physiological leptin administration on markers of inflammation, platelet activation, and platelet aggregation during caloric deprivation.
abstract: BACKGROUND
  Leptin is a nutritionally regulated adipocyte-derived cytokine. Previous studies in obese patients have demonstrated increased inflammatory markers and increased platelet aggregation in association with leptin. However, the effects of leptin administration on markers of inflammation and platelet aggregation in a human model of undernutrition have not previously been studied.
  
  
  OBJECTIVE
  The objective of the study was to investigate markers of inflammation, platelet activation, and platelet aggregation in a model of caloric deprivation and increased leptin sensitivity.
  
  
  METHODS
  This study was a randomized, placebo-controlled study conducted between November 2002 and November 2003.
  
  
  METHODS
  The study was conducted at an inpatient care setting at the General Clinical Research Center.
  
  
  METHODS
  Twenty healthy, young (18-35 yr old), normal-weight (body mass index, 20-26 kg/m2) women were recruited from local advertisements. No subjects withdrew due to adverse effects.
  
  
  METHODS
  The effects of physiological recombinant methionyl human leptin or identical placebo administration were investigated over a 4-d fast.
  
  
  METHODS
  The primary outcome measures for this study were C-reactive protein (CRP) and indices of platelet activity.
  
  
  RESULTS
  Leptin administration prevented the fasting-induced decline in leptin (P < 0.05 vs. placebo at each time point). Leptin administration increased CRP (6.3 +/- 2.4 vs. 0.7 +/- 0.3 mg/liter; P = 0.04), circulating P-selectin (11.6 +/- 10.2 vs. -28.9 +/- 15.6 ng/ml; P = 0.04), and induction of platelet aggregation (5.8 +/- 2.6 vs. -2.7 +/- 2.9%, P = 0.04, percent maximum platelet aggregation) relative to placebo administration (change in leptin vs. change in placebo, respectively, for each variable). Leptin tended to increase serum amyloid A [0.1 +/- 0.2 vs. -0.3 +/- 0.1 log10 (ng/ml); P = 0.07], and the changes in serum amyloid A and CRP were highly correlated (r = 0.83; P < 0.0001). No changes in TNFalpha, IL-6, IL-10, plasminogen activator inhibitor-1, haptoglobin, intercellular adhesion molecule, or vascular cell adhesion molecule were seen between the groups.
  
  
  CONCLUSIONS
  Our data provide evidence that physiological leptin administration stimulates inflammatory and platelet responses in humans during caloric deprivation.
authors.affiliation: Program in Nutritional Metabolism, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Bridget
authors.initials: B
authors.lastname: Canavan
authors.forename: Raneem O
authors.initials: RO
authors.lastname: Salem
authors.forename: Sunita
authors.initials: S
authors.lastname: Schurgin
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Koutkia
authors.forename: Izabella
authors.initials: I
authors.lastname: Lipinska
authors.forename: Michael
authors.initials: M
authors.lastname: Laposata
authors.forename: Steven
authors.initials: S
authors.lastname: Grinspoon
mesh_terms: D000328:Adult; D015415:Biomarkers; D001772:Blood Cell Count; D001823:Body Composition / Q000187:drug effects; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D002149:Energy Intake / Q000502:physiology*; D005215:Fasting / Q000502:physiology; D005260:Female; D005508:Food Deprivation / Q000502:physiology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D020738:Leptin / Q000009:adverse effects / Q000494:pharmacology*; D019007:P-Selectin / Q000378:metabolism; D015539:Platelet Activation / Q000187:drug effects*; D010974:Platelet Aggregation / Q000187:drug effects*; D010976:Platelet Count; D011994:Recombinant Proteins / Q000494:pharmacology
chemical_list: D015415:Biomarkers; D020738:Leptin; D019007:P-Selectin; D011994:Recombinant Proteins