Document Detail

Leptin and the post-operative inflammatory response. More insights into the correlation with the clinical course and glucocorticoid administration.
MedLine Citation:
PMID:  20386086     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Cardiac surgery involving cardiopulmonary bypass (CPB) causes a systemic inflammatory process which can lead to multiple organ failure and postoperative morbidity. Recent animal and human studies suggested a possible involvement of leptin in the systemic inflammatory response.
AIM: To characterize the response of leptin to open heart surgery (OHS) and the relationship between the time course of leptin levels and the post-operative clinical course, and to examine the effect of exogenous glucocorticoids.
PATIENTS AND METHODS: Forty-seven pediatric patients, undergoing OHS for congenital heart disease were studied. Thirty-four patients (Group 1) received methylprednisolone during CPB while 13 (group 2) did not. Serial blood samples were collected perioperatively and up to 24 h after surgery, and assayed for leptin and cortisol.
RESULTS: All patients' leptin levels decreased significantly during CPB (to 44-48% of baseline, p<0.001); they then increased, peaking at 12 h post-operatively. The levels of groups 1 and 2 were similar up to 8 h post-operatively; thereafter, those of group 1 were significantly higher. Recovery of leptin levels in patients with a more complicated post-operative course was comparatively slower. Cortisol levels of all patients increased significantly during CPB (p<0.001), gradually decreasing afterwards. Cortisol and leptin levels were inversely correlated in both patients' groups.
CONCLUSIONS: CPB is associated with acute changes in circulating leptin levels. A complicated postoperative course is associated with lower leptin levels which are inversely correlated with cortisol levels. Leptin may participate in post-CPB inflammatory and hemodynamic responses.
D Modan-Moses; H Kanety; O Dagan; S Ehrlich; D Lotan; C Pariente; I Novikov; G Paret
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Publication Detail:
Type:  Journal Article     Date:  2010-04-12
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  33     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  701-6     Citation Subset:  IM    
Pediatric Endocrinology Unit, the Edmond and Lily Safra Children's Hospital, Tel Aviv, Israel.
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