title: Relation of leptin, ghrelin and inflammatory cytokines with body mass index in pulmonary tuberculosis patients with and without type 2 diabetes mellitus.
abstract: BACKGROUND
  Pulmonary tuberculosis (TB) patients often suffer from anorexia and poor nutrition, causing weight loss. The peptide hormones leptin and its counterpart ghrelin, acting in the regulation of food intake and fat utilization, play an important role in nutritional balance. This study aimed to investigate the association of blood concentrations of leptin, ghrelin and inflammatory cytokines with body mass index (BMI) in TB patients with and without type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  BMI, biochemical parameters and plasma levels of leptin, ghrelin and inflammatory cytokines were measured before the start of treatment in 27 incident TB patients with T2DM, 21 TB patients and 23 healthy subjects enrolled in this study.
  
  
  RESULTS
  The levels of leptin were significantly higher in TB patients (35.2 ± 19.1 ng/ml) than TB+T2DM (12.6 ± 6.1 ng/ml) and control (16.1 ± 11.1 ng/ml) groups. The level of ghrelin was significantly lower in TB (119.9 ± 46.1 pg/ml) and non-significantly lower in TB+T2DM (127.7 ± 38.6 pg/ml) groups than control (191.6 ± 86.5 pg/ml) group. The levels of TNF-α were higher, while IFN-γ and IL-6 levels were lower in patients than in the control group. Leptin showed a negative correlation with BMI in TB (r=-0.622, p<0.05) and TB+T2DM (r= -0.654, p<0.05) groups, but a positive correlation with BMI in the control group (r=0.521, p<0.05). Contrary ghrelin showed a positive correlation with BMI in TB (r=0.695, p<0.05) and TB+T2DM (r= 0.199, p>0.05) groups, but negative correlation with BMI in the control (r=-0.693, p<0.05) group. Inflammatory cytokines were poorly correlated with BMI in this study. Only IFN-γ showed a significant negative correlation with BMI in the control group (r=-0.545, p<0.05).
  
  
  CONCLUSIONS
  This study may suggest that possible abnormalities in ghrelin and leptin regulation (high levels of leptin and low levels of ghrelin) may be associated with low BMI and may account for the poor nutrition associated with TB and TB+T2DM.
authors.affiliation: Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, P. R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zheng
authors.forename: Aiguo
authors.initials: A
authors.lastname: Ma
authors.forename: Qiuzhen
authors.initials: Q
authors.lastname: Wang
authors.forename: Xiuxia
authors.initials: X
authors.lastname: Han
authors.forename: Jing
authors.initials: J
authors.lastname: Cai
authors.forename: Evert G
authors.initials: EG
authors.lastname: Schouten
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
authors.forename: Yunchun
authors.initials: Y
authors.lastname: Li
mesh_terms: D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000378:metabolism; D007371:Interferon-gamma / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000503:physiopathology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D054439:Ghrelin; D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma