title: Relevance of serum leptin and leptin-receptor concentrations in critically ill patients.
abstract: The adipocyte-derived cytokine leptin was implicated to link inflammation and metabolic alterations. We investigated the potential role of leptin components in critically ill patients, because systemic inflammation, insulin resistance, and hyperglycemia are common features of critical illness. Upon admission to Medical Intensive Care Unit (ICU), free leptin and soluble leptin-receptor serum concentrations were determined in 137 critically ill patients (95 with sepsis, 42 without sepsis) and 26 healthy controls. Serum leptin or leptin-receptor did not differ between patients or controls and were independent of sepsis. However, serum leptin was closely associated with obesity and diabetes and clearly correlated with markers of metabolism and liver function. Leptin-receptor was an unfavourable prognostic indicator, associated with mortality during three years follow-up. Our study indicates a functional role of leptin in the pathogenesis of severe illness and emphasizes the impact of complex metabolic alterations on the clinical outcome of critically ill patients.
authors.affiliation: Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany. akoch@ukaachen.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Koch
authors.forename: Ralf
authors.initials: R
authors.lastname: Weiskirchen
authors.forename: Henning W
authors.initials: HW
authors.lastname: Zimmermann
authors.forename: Edouard
authors.initials: E
authors.lastname: Sanson
authors.forename: Christian
authors.initials: C
authors.lastname: Trautwein
authors.forename: Frank
authors.initials: F
authors.lastname: Tacke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D020738:Leptin / Q000097:blood*; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000503:physiopathology; D011379:Prognosis; D054411:Receptors, Leptin / Q000097:blood*; D018805:Sepsis / Q000097:blood; D055815:Young Adult
chemical_list: D020738:Leptin; D054411:Receptors, Leptin; D005947:Glucose