LEPTIN, A NEW PROINFLAMMATORY MARKER AND BODY COMPOSITION – CORRELATIONS DURING EARLY POSTOPERATIVE PERIOD AFTER MAJOR SURGERY
Irina Ristescu (1,4*), Ioana Grigoraș (1,4), Didona Ungureanu (2,4),
D. Rusu (1), D. Brănişteanu (3,4)
(*) PhD student “Gr.T.Popa” University of Medicine and Pharmacy Iaşi
(1) Intensive Care, “Gr.T.Popa” University of Medicine and Pharmacy Iaşi
(2) Imunology Department, “Gr.T.Popa” University of Medicine and Pharmacy Iaşi
(3) Endocrinology Clinic, “Gr.T.Popa” University of Medicine and Pharmacy Iaşi
(4) St Spiridon University Hospital Iaşi
Jurnalul de chirurgie 2011; 7 (4): 582-595
Full text: Format PDF (Română/Romanian)

Abstract:

Introduction: Leptin is an adipokine regulating energy balance but recently has been related to immune system and inflammatory response. Objectives: To investigate the correlation between leptin plasma level and body composition in patients with signs of systemic inflammatory response syndrome after major abdominal surgery and to characterise early dynamics of this and other proinflamatory cytokines in such patients. Methods: We prospectivelly enrolled 40 patients divided in 2 groups: study group (20 pts) – patients with major abdominal surgery and signs of SIRS and control group (20 pts) – preoperative patients without inflammatory disease. Plasma concentration of leptin, CPR and IL6 were measured preoperatively in both groups and in first three days postoperative (9 samples) in the study group. Body composition (percent of body fat, lean body mass, total body water) was recorded using bioelectrical impedance analysis method.  Results: In control group leptin has a positive correlation (r2=0.52) with the percent of body fat. In study group this correlation is present (r=0.85) preoperatively  but is lost at 24,48 and 72 hours postoperative measurements (r=0.04, 0.07, 0.15). In study group  leptin acts as a pro-inflammatory cytokine. The plasmatic peak of 17.31 ng/ml is reached at 12 h, later than IL 6 (plasmatic peak at 6h) but earlier comparing with CRP (plasmatic peak at 24h). Conclusions: In patients with major abdominal surgery and SIRS leptin acts as a proinflammatory mediator with mainly extraadipocitary source. Leptin has  specific  early dynamics and may be useful as  an early diagnostic marker of systemic inflammation.

KEY WORDS: LEPTIN, BODY COMPOSITION, BIOELECTRICAL IMPEDANCE ANALYSIS, PERCENT OF BODY FAT

Correspondence to: Irina Ristescu, MD Adress: University Emergency Hospital “Sf. Spiridon”, Anestesia and Intensive Care Departament, bd. Independenței 1, 700111, Iași, Romania, Phone: +40744762900, e-mail adress: