title: Are Adiponectin and Leptin Good Predictors of Surgical Infection after Colorectal Surgery? A Prospective Study.
abstract: BACKGROUND
  Infections are the most frequent complication after colorectal surgery. It has been suggested that adipose tissue metabolism could be related to the risk of post-operative infection, but this could be partially related to the body-mass index. The aim of this study was to look for a relation between adipocytokine levels and the risk of post-operative infection and its type.
  
  
  METHODS
  This prospective cohort study was conducted between March 2013 and March 2014 in two French teaching hospitals. Pre-operative plasma levels of adiponectin and leptin were measured in consecutive patients undergoing elective colorectal surgery. All infections in the 30 d following surgery were recorded.
  
  
  RESULTS
  Among the 142 patients included, 29 (20.4%) presented a post-operative infection: 26 surgical site infections and three extra-abdominal infections. Adiponectin and leptin levels correlated weakly but substantially with the body mass index (rspearman=-0.26 and +0.31, respectively). While there was no substantial difference between patients with and those without post-operative infection for adiponectin, median pre-operative leptin was substantially greater in patients with post-operative infection (8.67 vs. 4.37 ng/mL, p=0.003). A substantial interaction was found between leptin and cancer. In patients operated on for cancer, the area under the receiver-operating characteristic (ROC) curve was lower than in patients with benign diseases (0.597 vs. 0.858, p=0.011). Similar results were observed for intra-abdominal infection and surgical site infection.
  
  
  CONCLUSIONS
  Patients with greater levels of leptin before colorectal surgery have an increased risk of post-operative surgical infection. This effect is stronger in patients without cancer. Adiponectin levels are not related to the risk of infection in Western patients.
authors.affiliation: 1 Department of Digestive Surgery, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France .|4 INSERM, U866, Dijon, France; University of Burgundy , School of Health, Dijon, France .
authors.forename: Pablo
authors.initials: P
authors.lastname: Ortega-Deballon
authors.affiliation: 2 Department of Biochemistry, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France .
authors.forename: Louise
authors.initials: L
authors.lastname: Ménégaut
authors.affiliation: 3 Department of Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France .
authors.forename: Isabelle
authors.initials: I
authors.lastname: Fournel
authors.affiliation: 5 Department of Surgical Oncology, Georges-François Leclerc Anticancer Centre , Dijon, France .
authors.forename: David
authors.initials: D
authors.lastname: Orry
authors.affiliation: 2 Department of Biochemistry, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France .|4 INSERM, U866, Dijon, France; University of Burgundy , School of Health, Dijon, France .
authors.forename: David
authors.initials: D
authors.lastname: Masson
authors.affiliation: 3 Department of Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France .|4 INSERM, U866, Dijon, France; University of Burgundy , School of Health, Dijon, France .
authors.forename: Christine
authors.initials: C
authors.lastname: Binquet
authors.affiliation: 1 Department of Digestive Surgery, Clinical Epidemiology/Clinical Trials, University Hospital of Dijon , Dijon, France .|4 INSERM, U866, Dijon, France; University of Burgundy , School of Health, Dijon, France .
authors.forename: Olivier
authors.initials: O
authors.lastname: Facy
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery / Q000009:adverse effects*; D005260:Female; D005602:France / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000453:epidemiology*
chemical_list: D052242:Adiponectin; D020738:Leptin