title: Leptin levels after subarachnoid haemorrhage are gender dependent.
abstract: BACKGROUND
  Subarachnoid hemorrhage (SAH) is a neurological disease where the majority of the patients are critically ill. The adipokine leptin has in cerebral emergencies been related to severity of disease and to adverse outcome. The aim of this study was to examine leptin levels over time after SAH and associations to gender, age, body mass index, severity of disease, parenteral lipids, systemic organ failure and outcome.
  
  
  METHODS
  Prospective observational study in 56 patients. Leptin was obtained 0-240 h after SAH, in 48 h intervals. Severity of disease was assessed with the Hunt and Hess score, organ failure with the sequential organ failure assessment score, and outcome with Glasgow outcome scale. Leptin levels in the SAH group were compared with controls from the same geographical area.
  
  
  RESULTS
  At admission, Leptin was significantly higher in SAH patients compared to controls, both in female (28.6 ± 25.6 vs 13.0 ± 2.3 ng/mL, p = 0.001) and male patients (13.3 ± 8.4 vs 4.3 ± 0.7 ng/mL, p = 0.001). Leptin levels remained stable over time. Female patients had significantly higher leptin levels than male patients, and deceased female patients had higher leptin levels than female survivors (85.5 ± 20.5 vs 50.5 ± 34.6, n = 4/35, p < 0.05). Leptin levels did not differ between male survivors and non-survivors. Leptin levels were not associated with severity of disease, organ failure or parenteral lipids.
  
  
  CONCLUSIONS
  Leptin levels were significantly higher in both male and female patients compared to controls. Higher leptin levels were related to outcome and organ failure in women but not in men. When analysing leptin levels gender-related differences should be considered.
authors.affiliation: Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care, Umeå University, Umeå, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Lindgren
authors.affiliation: Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Silvana
authors.initials: S
authors.lastname: Naredi
authors.affiliation: Department of Public Health and Clinical Medicine, Medicine and Heart Centre, Umeå University, Umeå, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Söderberg
authors.affiliation: Department of Pharmacology and Clinical Neuroscience, Neurosurgery, Umeå University, Umeå, Sweden.
authors.forename: Lars-Owe
authors.initials: LO
authors.lastname: Koskinen
authors.affiliation: Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care, Umeå University, Umeå, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Hultin
keywords: Gender; Leptin; Organ failure; Outcome; Subarachnoid haemorrhage