title: Serum leptin and cytokines in whole blood in relation to clinical and nutritional status in cystic fibrosis.
abstract: 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.
authors.affiliation: Children's Hospital Medical Center, University of Bonn, Germany. s.schmitt.grohe@uni-bonn.de
authors.forename: Sabina
authors.initials: S
authors.lastname: Schmitt-Grohé
authors.forename: Valerie
authors.initials: V
authors.lastname: Hippe
authors.forename: Michael
authors.initials: M
authors.lastname: Igel
authors.forename: Klaus
authors.initials: K
authors.lastname: von Bergmann
authors.forename: Hans G
authors.initials: HG
authors.lastname: Posselt
authors.forename: Andreas
authors.initials: A
authors.lastname: Krahl
authors.forename: Christina
authors.initials: C
authors.lastname: Smaczny
authors.forename: Thomas O F
authors.initials: TO
authors.lastname: Wagner
authors.forename: Wilfried
authors.initials: W
authors.lastname: Nikolaizik
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lentze
authors.forename: Stefan
authors.initials: S
authors.lastname: Zielen
mesh_terms: 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
chemical_list: D016207:Cytokines; D016209:Interleukin-8; D020738:Leptin; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha