Elsevier

Peptides

Volume 43, May 2013, Pages 133-136
Peptides

Prognostic value of leptin: 6-Month outcome in patients with intracerebral hemorrhage

https://doi.org/10.1016/j.peptides.2013.03.010Get rights and content

Highlights

  • High plasma leptin level is found in patients with ICH.

  • Leptin could emerge as a new biomarker in ICH.

  • Leptin independently predicts long-term outcome in patients with ICH.

Abstract

Leptin has recently been discussed as a novel biomarker for the clinical outcome of critical illness. This study aims to investigate the prognostic value of leptin with regard to long-term clinical outcomes in patients with intracerebral hemorrhage. In 50 healthy controls and 92 patients with acute spontaneous basal ganglia hemorrhage presenting to the emergency department of a large primary care hospital, we measured plasma leptin levels using an enzyme-linked immunosorbent assay in a blinded fashion. Plasma leptin levels on admission were considerably higher in patients than healthy controls. A significant correlation emerged between plasma leptin level and National Institutes of Health Stroke Scale score. A multivariate analysis identified plasma leptin level as an independent predictor for 6-month clinical outcomes including 6-month mortality and unfavorable outcome (Modified Rankin Scale score > 2). Using receiver operating characteristic curves, we calculated areas under the curve for 6-month clinical outcomes. The predictive performance of leptin was similar to, but did not obviously improve that of National Institutes of Health Stroke Scale scores. Thus, leptin may help in the prediction of 6-month mortality and unfavorable outcome after intracerebral hemorrhage.

Introduction

Leptin, the 16,000 Da protein product of the obesity gene (ob), is principally derived from white adipose tissue, and not only acts on the central nervous system to reduce appetite and increase energy expenditure, but also plays crucial roles in regulating inflammation and immune [1], [4], [8], [9], [13], [14], [15]. Present investigations on animals have found that brain cortex leptin mRNA expression and serum leptin level are up-regulated in mouse with ischemic brain injury and in rat with traumatic brain injury [2], [6], [18]. Moreover, leptin levels in peripheral blood are highly associated with cerebral hemorrhagic or ischemic stroke [16], [17], and independently predict in-hospital and 1-week mortality of patients with intracerebral hemorrhage (ICH) and 6-month clinical outcome of pediatric traumatic brain injury [7], [11], [19]. This follow-up study further evaluated leptin as a marker to predict long-term functional outcome and mortality at 6 months after admission in acute ICH patients.

Section snippets

Study population

This prospective study was conducted during the period of January 2010–March 2012 by the Department of Neurosurgery, Traditional Chinese Medical Hospital of Zhejiang Province. The consecutive patients with acute spontaneous basal ganglia hemorrhage were evaluated within 6 h from symptoms onset at the emergency room. Exclusion criteria included existing previous neurological disease, head trauma, use of antiplatelet or anticoagulant medication, presence of other prior systemic diseases including

Study population's characteristics

Finally, 92 ICH patients and 50 healthy controls were enrolled in this study. The intergroup differences in age, gender and body mass index were not statistically significant (all P > 0.05). The demographic, clinical and laboratory data of patients were provided in Table 1. The admission leptin levels were significantly increased in all patients (19.1 ± 7.7 ng/mL) compared with healthy control individuals (7.9 ± 3.3 ng/mL, P < 0.001). A significant correlation emerged between plasma leptin level and

Discussion

Recent two studies have demonstrated that leptin levels in peripheral blood independently predict in-hospital and 1-week mortality of the patients with ICH [7], [19]. To the best of our knowledge, this study is among few studies that analyzed the association of plasma leptin level with long-term clinical outcomes in ICH. This study demonstrated that the plasma leptin levels on admission is considerably increased and markedly predicts 6-month clinical outcomes. Importantly, the prognostic value

Conclusions

This study suggests that higher plasma leptin level correlates with disease severity and markers of system inflammation and represents a novel biomarker for predicting 6-month clinical outcomes in patients with ICH.

Competing interests

The authors declare that they have no competing interests.

References (19)

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Institution at which the work was performed: Traditional Chinese Medical Hospital of Zhejiang Province.

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