title: Plasma leptin levels increase to a greater extent following on-pump coronary artery surgery in type 2 diabetic patients than in nondiabetic patients.
abstract: OBJECTIVE
  We aimed to evaluate whether leptin and ghrelin responses to cardiopulmonary bypass (CPB) are dependent on type 2 diabetes and whether these responses are associated with interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), cortisol and insulin.
  
  
  METHODS
  We examined stress-response patterns in plasma leptin, ghrelin, hsCRP, IL-6, cortisol and insulin levels before and up to 5 days after cardiopulmonary bypass in 20 patients with type 2 diabetes and 20 patients without diabetes.
  
  
  RESULTS
  Plasma leptin levels increased significantly in both groups (p<0.05) and rose significantly higher in diabetics when compared with nondiabetic patients (p=0.004). Plasma ghrelin levels increased significantly only in diabetics (p=0.033). Patients with and without diabetes showed significantly elevated serum concentrations of IL-6, hsCRP, cortisol and insulin (p<0.005 for IL-6, hsCRP; p<0.05 for cortisol, insulin) but the difference between the two groups was nonsignificant. Leptin was independently predicted by hsCRP (p<0.05, F=2.9), gender (women p<0.001, F=4.7), body mass index (BMI p<0.0001, F=6.1) whereas ghrelin levels were not associated with any variables in the total patient population. (critical F=2.26, p≤0.05).
  
  
  CONCLUSIONS
  Acute phase response in diabetics differs by higher leptin levels independent of BMI, gender and IL-6, hsCRP, insulin and cortisol levels.
authors.affiliation: Department of Cardiovascular Surgery, Başkent University Adana Medical Center, Yüreğir, Adana, Turkey. guvener@doctor.com
authors.forename: Murat
authors.initials: M
authors.lastname: Guvener
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Ucar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Oc
authors.forename: Asli
authors.initials: A
authors.lastname: Pinar
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002315:Cardiopulmonary Bypass; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D003925:Diabetic Angiopathies / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007328:Insulin / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D054439:Ghrelin; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D002097:C-Reactive Protein; D006854:Hydrocortisone