Prognostic value of leptin: 6-Month outcome in patients with 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)
- et al.
Adipokines that link obesity and diabetes to the hypothalamus
Prog Brain Res
(2006) - et al.
Leptin enters the brain by a saturable system independent of insulin
Peptides
(1996) - et al.
Traumatic brain injury induces adipokine gene expression in rat brain
Neurosci Lett
(2008) - et al.
Time course of plasma leptin concentrations after acute spontaneous basal ganglia hemorrhage
World Neurosurg
(2010) Adipose tissue, adipokines, and inflammation
J Allergy Clin Immunol
(2005)- et al.
Relationship between plasma leptin levels and clinical outcomes of pediatric traumatic brain injury
Peptides
(2012) - et al.
Leptin is induced in the ischemic cerebral cortex and exerts neuroprotection through NF-kappaB/c-Rel-dependent transcription
Stroke
(2009) - et al.
Expression and release of leptin and proinflammatory cytokines in patients with ulcerative colitis and infectious diarrhea
J Physiol Pharmacol
(2012) - et al.
Early hemorrhage growth in patients with intracerebral hemorrhage
Stroke
(1997)
Cited by (0)
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Institution at which the work was performed: Traditional Chinese Medical Hospital of Zhejiang Province.