Circulating leptin levels after cardiopulmonary bypass in children
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Published on: October 25, 2019
D Modan-Moses1, H Kanety, O Dagan
1Department of Pediatric Intensive Care, The Chaim Sheba and Schneider Medical Centers, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Cardiopulmonary bypass (CPB) in children undergoing heart surgery causes significant changes in leptin levels. These leptin dynamics are inversely related to cortisol, suggesting a neuroendocrine link post-surgery.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Surgery
- Neuroendocrinology
Background:
- Cardiopulmonary bypass (CPB) in pediatric cardiac surgery is known to trigger a systemic inflammatory response.
- Leptin, a hormone regulating energy balance, may be affected by the physiological stress of CPB.
- Understanding leptin dynamics is crucial for assessing the neuroendocrine response in children post-cardiac surgery.
Purpose of the Study:
- To investigate the dynamic changes in circulating leptin levels in children following cardiac surgery that involves CPB.
- To explore the relationship between leptin and cortisol levels in this pediatric population during the perioperative period.
Main Methods:
- An investigative study was conducted at a tertiary care hospital.
- Eight children (3 months to 13 years) undergoing CPB for congenital heart disease were enrolled.
- Serial blood samples were collected preoperatively, during CPB, and at multiple time points up to 24 hours postoperatively for leptin and cortisol analysis.
Main Results:
- Leptin levels significantly decreased by 50% during CPB (p < 0.01).
- Post-CPB, leptin levels gradually increased, peaking at 12 hours postoperatively.
- A significant inverse correlation was observed between leptin and cortisol levels (p = 0.016).
Conclusions:
- CPB induces acute alterations in circulating leptin levels in children.
- The observed parallel changes and inverse relationship between leptin and cortisol suggest a neurobiological connection.
- Further research is warranted to explore the prognostic role of leptin and its interaction with cortisol after CPB.
Objective:
To characterize the dynamics of circulating leptin in children after cardiac surgery with cardiopulmonary bypass (CPB), which is known to induce a systemic inflammatory response.
Design:
Investigative study.
Setting:
University-affiliated tertiary care hospital.
Participants:
Eight children (age range, 3 months to 13 years) undergoing CPB to correct congenital heart disease.
Interventions:
The time courses of leptin and cortisol levels were determined. Serial blood samples were collected from the arterial catheter or from the CPB circuit preoperatively; on termination of CPB; and at 2, 4, 8, 12, 18, and 24 hours postoperatively. Plasma was recovered immediately, divided into aliquots, and frozen at -70 degrees C until use. Leptin was measured by a human leptin radioimmunoassay kit.
Measurements And Main Results:
Leptin levels during CPB decreased to 50% of pre-CPB levels (p < 0.01). After termination of CPB, levels increased gradually and peaked at 12 hours postoperatively (10 P.M. to 1 A.M.). Cortisol levels were inversely correlated to leptin levels (p = 0.016).
Conclusion:
CPB is associated with acute changes in circulating leptin levels. These changes parallel those in cortisol, showing an inverse relationship between leptin and cortisol, suggesting a relationship between the neurobiology of these systems that could be important for the neuroendocrine response to CPB. A prognostic role of leptin and its relationship to cortisol after CPB warrant further study.
