Elevated cerebrospinal fluid (CSF) leptin in idiopathic intracranial hypertension (IIH): evidence for hypothalamic leptin resistance?
OBJECTIVE
The aetiology of idiopathic intracranial hypertension (IIH) is not known, but its association with obesity is well-recognized. Recent studies have linked obesity with abnormalities in circulating inflammatory and adiposity related cytokines. The aim of this study was to characterize adipokine and inflammatory cytokine profiles in IIH.


METHODS
Paired serum and cerebrospinal fluid (CSF) specimens were collected from 26 patients with IIH and compared to 62 control subjects. Samples were analysed for leptin, resistin, adiponectin, insulin, IL-1beta, IL-6, IL-8 (CXCL8), TNFalpha, MCP-1 (CCL2), hepatocyte growth factor, nerve growth factor and PAI-1 using multiplex bead immunoassays.


RESULTS
CSF leptin was significantly higher in patients with IIH (P = 0.001) compared to controls after correction for age, gender and body mass index (BMI). In the control population, BMI correlated with serum leptin (r = 0.34; P = 0.007) and CSF leptin (r = 0.51; P < 0.0001), but this was not the case for the IIH population. Profiles of other inflammatory cytokines and adipokines did not differ between IIH patients and controls once anthropometric factors had been accounted for.


CONCLUSIONS
IIH was characterized by significantly elevated CSF leptin levels which did not correlate with BMI. We suggest that CSF leptin may be important in the pathophysiology of IIH and that obesity in IIH may occur as a result of hypothalamic leptin resistance.
Ball
A K
AK
Department of Neurology, School of Experimental Medicine, University of Birmingham, Birmingham, UK.
Sinclair
A J
AJ
Curnow
S J
SJ
Tomlinson
J W
JW
Burdon
M A
MA
Walker
E A
EA
Stewart
P M
PM
Nightingale
P G
PG
Clarke
C E
CE
Rauz
S
S
D054392:Adipokines / Q000097:blood / Q000134:cerebrospinal fluid; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood / Q000134:cerebrospinal fluid; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects / Q000503:physiopathology*; D020738:Leptin / Q000097:blood / Q000134:cerebrospinal fluid*; D008875:Middle Aged; D011559:Pseudotumor Cerebri / Q000097:blood / Q000134:cerebrospinal fluid / Q000503:physiopathology*
D054392:Adipokines; D016207:Cytokines; D020738:Leptin