Serum leptin and cytokines in whole blood in relation to clinical and nutritional status in cystic fibrosis.
OBJECTIVE
Leptin plays an important role in the energy balance and may be affected by hormonal and metabolic derangement associated with chronic disease. The aim of this study was to assess the correlation between leptin, proinflammatory cytokines and nutritional status with regard to clinical status in homozygous delta F 508 cystic fibrosis patients.


METHODS
Patients with mild (Shwachman score 71-100 points, group A) disease were compared with those with moderate disease (Shwachman score 41-55 points, group B) and age-matched controls (group C, n = 22). Leptin was assessed by enzyme-linked immunosorbent assay and cytokines (interleukin-8, tumor necrosis factor alpha) before and after stimulation with 5 ng lipopolysaccharide by a chemiluminescent immunometric assay.


RESULTS
Twenty-two patients were recruited for each group (median A/B/C forced expiratory volume in 1 second 80%/59%/-; median age 12/13.5/12.5 years). Leptin (median 3.25/2.65/3.3 pg/mL; P = 0.083) and body mass index were lower (group A/B/C 18.55/16.75/20.5 kg/m(2); P = 0.023), but dietary intake was significantly higher (group A/B/C 50.5/68/43 kcal/kg body weight; P = 0.026) in moderate disease. Cytokines before stimulation with lipopolysaccharide were highest in moderate disease, but there was no significant difference after stimulation (interleukin-8 median A/B/C before--15/25.1/8.0 pg/mL, P < 0.005; after--570.5/573.5/415.5 pg/mL, not significant; tumor necrosis factor alpha median A/B/C 43/56/30 pg/mL, P < 0.0001; 580/427/720.5 pg/mL, not significant.).


CONCLUSIONS
There is a physiological regulation of leptin even in more advanced states of disease with significantly lower body mass index than controls. However, our data do not support the idea of elevated cytokine levels inducing anorexia in homozygous delta F 508 cystic fibrosis patients.
Schmitt-Grohé
Sabina
S
Children's Hospital Medical Center, University of Bonn, Germany. s.schmitt.grohe@uni-bonn.de
Hippe
Valerie
V
Igel
Michael
M
von Bergmann
Klaus
K
Posselt
Hans G
HG
Krahl
Andreas
A
Smaczny
Christina
C
Wagner
Thomas O F
TO
Nikolaizik
Wilfried
W
Lentze
Michael J
MJ
Zielen
Stefan
S
D000293:Adolescent; D000328:Adult; D000855:Anorexia / Q000209:etiology; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000097:blood*; D016207:Cytokines / Q000096:biosynthesis / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D016209:Interleukin-8 / Q000097:blood; D020738:Leptin / Q000097:blood* / Q000502:physiology; D008070:Lipopolysaccharides / Q000494:pharmacology; D049449:Luminescence; D008297:Male; D009752:Nutritional Status; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha
D016207:Cytokines; D016209:Interleukin-8; D020738:Leptin; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha