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Leptin and interleukin-6 in sepsis
D J Torpy1, S R Bornstein, G P Chrousos
1Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892-1862, USA.
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|February 4, 1999
Summary
In critical illness like sepsis, high interleukin-6 (IL-6) and low leptin levels correlate with poor outcomes. This study found a negative relationship between IL-6 and leptin, impacting survival in sepsis patients.
Area of Science:
- Endocrinology
- Immunology
- Critical Care Medicine
Background:
- Leptin and interleukin-6 (IL-6) are elevated in acute critical illness, such as sepsis.
- Leptin affects appetite and sympathetic activity, while IL-6 modulates inflammation and acute phase responses.
- The roles of leptin and IL-6 in critical illness prognosis, particularly their interaction with cortisol, remain unclear.
Purpose of the Study:
- To investigate the relationship between IL-6, leptin, and cortisol in patients with acute sepsis.
- To determine the prognostic significance of these hormone levels for survival in critical illness.
Main Methods:
- Frequent plasma sampling (every 4 hours) over 5 days in eight sepsis patients.
- Analysis of leptin, IL-6, and cortisol levels, including diurnal rhythmicity.
- Correlation analysis between hormone levels and patient survival.
Main Results:
- Markedly elevated leptin, IL-6, and cortisol levels were observed, with blunted diurnal rhythms.
- A strong negative correlation was found between mean 24-hour plasma IL-6 and leptin levels.
- Non-survivors exhibited significantly higher IL-6 and lower leptin levels compared to survivors.
Conclusions:
- IL-6 is unlikely to be the primary driver of leptin hypersecretion in sepsis.
- The inverse relationship between IL-6 and leptin may have significant implications for critical illness outcomes.
- Low leptin levels in sepsis, despite high IL-6, could impair crucial sympathetic and immune functions, contributing to poorer prognosis.