Circulating leptin, soluble leptin receptor and free leptin index in critically ill patients with sepsis: a prospective observational study

Karampela, Ιrene; Chrysanthopoulou, Evangelia; Skyllas, George; Christodoulatos, Gerasimos Socrates; Kandri, Evangelia; Antonakos, Georgios; Stratigou, Theodora; Armaganidis, Apostolos

doi:10.23736/s0375-9393.21.15368-4

Cited by 13 publications

(17 citation statements)

References 37 publications

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“…Upon infection, patients with excessive fat mass would be prone to produce more leptin. High levels of leptin were associated with inflammatory mediators and disease severity in obese and not obese patients ( Vernooy et al, 2013 ; Birlutiu and Boicean, 2021 ; Karampela et al, 2021 ; Wang et al, 2021 ). A state of low-grade, chronic inflammation, as observed in obesity, has been associated with altered leptin levels, impaired immune system, and host defenses: obese subjects are more susceptible to respiratory virus infection, to a greater severity of illness prolonged viral shed, increased viral diversity, and adverse endpoints after diseases, until death ( Andersen et al, 2016 ; Aquino-Junior et al, 2018 ).…”

Section: Leptin At a Glancementioning

confidence: 98%

“…High leptin concentrations are directly associated with obesity and/or the subsequent development of metabolic disease sequelae, such as insulin resistance, type 2 diabetes, and cardiovascular diseases ( Ghadge and Khaire, 2019 ), all key risk factors associated with increased coronavirus disease 2019 (COVID-19) mortality ( Kim et al, 2021 ; Mohammad et al, 2021 ). In addition, it has been assessed that an increased leptinemia is observed not only in patients with obesity and metabolic syndrome but also in patients who are not obese but affected by other inflammatory diseases, such as sepsis and respiratory infections ( Vernooy et al, 2013 ; Birlutiu and Boicean, 2021 ; Karampela et al, 2021 ). Furthermore, increased value of leptin is one of the factors that raised the risk of non-alcoholic fatty liver disease presence in patients with prediabetes ( Vesa et al, 2020 ) as well, after adjusting for body mass index (BMI) or fat mass, serum leptin levels result positively and independently associated with peripheral artery disease ( Zahner et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

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Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection?

et al. 2021

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Leptin is a pleiotropic adipocytokine involved in several physiologic functions, with a known role in innate and adaptive immunity as well as in tissue homeostasis. Long- and short-isoforms of leptin receptors are widely expressed in many peripheral tissues and organs, such as the respiratory tract. Similar to leptin, microbiota affects the immune system and may interfere with lung health through the bidirectional crosstalk called the “gut-lung axis.” Obesity leads to impaired protective immunity and altered susceptibility to pulmonary infections, as those by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although it is known that leptin and microbiota link metabolism and lung health, their role within the SARS-CoV2 coronavirus disease 2019 (COVID-19) deserves further investigations. This review aimed to summarize the available evidence about: (i) the role of leptin in immune modulation; (ii) the role of gut microbiota within the gut-lung axis in modulating leptin sensitivity; and (iii) the role of leptin in the pathophysiology of COVID-19.

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Section: Leptin At a Glancementioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection?

et al. 2021

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“…Various adipokines, i.e., hormones derived mainly from the adipose tissue, exert immunomodulatory actions, being implicated in the inflammatory response during sepsis [ 31 , 32 , 33 , 34 ]. Previous studies have highlighted that circulating adipokines are altered during sepsis in critically ill patients and may serve as diagnostic and prognostic biomarkers [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. However, chemerin has not been thoroughly studied in sepsis.…”

Section: Introductionmentioning

confidence: 99%

Circulating Chemerin and Its Kinetics May Be a Useful Diagnostic and Prognostic Biomarker in Critically Ill Patients with Sepsis: A Prospective Study

et al. 2022

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Chemerin, a novel adipokine, is a potent chemoattractant molecule with antimicrobial properties, implicated in immune responses. Our aim was to investigate circulating chemerin and its kinetics, early in sepsis in critically ill patients and its association with severity and prognosis. Serum chemerin was determined in a cohort of 102 critically ill patients with sepsis during the first 48 h from sepsis onset and one week later, and in 102 age- and gender-matched healthy controls. Patients were followed for 28 days and their outcomes were recorded. Circulating chemerin was significantly higher in septic patients at onset compared to controls (342.3 ± 108.1 vs. 200.8 ± 40.1 μg/L, p < 0.001). Chemerin decreased significantly from sepsis onset to one week later (342.3 ± 108.1 vs. 308.2 ± 108.5 μg/L, p < 0.001), but remained higher than in controls. Chemerin was higher in patients presenting with septic shock than those with sepsis (sepsis onset: 403.2 ± 89.9 vs. 299.7 ± 99.5 μg/L, p < 0.001; one week after: 374.9 ± 95.3 vs. 261.6 ± 91.9 μg/L, p < 0.001), and in nonsurvivors than survivors (sepsis onset: 427.2 ± 96.7 vs. 306.9 ± 92.1 μg/L, p < 0.001; one week after: 414.1 ± 94.5 vs. 264.2 ± 79.9 μg/L, p < 0.001). Moreover, patients with septic shock and nonsurvivors, presented a significantly lower absolute and relative decrease in chemerin one week after sepsis onset compared to baseline (p < 0.001). Based on ROC curve analyses, the diagnostic performance of chemerin (AUC 0.78, 95% CI 0.69–0.87) was similar to C-reactive protein (CRP) (AUC 0.78, 95% CI 0.68–0.87) in discriminating sepsis severity. However, increased chemerin at sepsis onset and one week later was an independent predictor of 28-day mortality (sepsis onset: HR 3.58, 95% CI 1.48–8.65, p = 0.005; one week after: HR 10.01, 95% CI 4.32–23.20, p < 0.001). Finally, serum chemerin exhibited significant correlations with the severity scores, white blood cells, lactate, CRP and procalcitonin, as well as with biomarkers of glucose homeostasis, but not with cytokines and soluble urokinase-type plasminogen activator receptor (suPAR). Circulating chemerin is increased early in sepsis and its kinetics may have diagnostic and prognostic value in critically ill patients. Further studies are needed to shed light on the role of chemerin in sepsis.

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“…Meta-analyses of population-based studies have reported that obesity and diabetes mellitus are significant and independent risk factors for COVID-19 severity, hospitalization, ICU admission, and death in subjects with COVID-19 [ 5 , 6 ]. However, independently from pre-existing DM, hyperglycemia is a biomarker of unfavorable prognosis, being associated with nosocomial adverse outcomes, risk of developing acute respiratory distress syndrome (ARDS) and a 7-fold increased mortality in comparison to well-controlled glycemia [ [7] , [8] , [9] , [10] ].…”

mentioning

confidence: 99%

“…Altered glucose homeostasis, considered a tailored response for an effective immune response in infection, is attributed to the following physiological mechanisms: 1) the hypersecretion of inflammatory cytokines, particularly interleukin (IL)-6, IL-1b, and tumor necrosis factor (TNF)-α; 2) the enhanced hypothalamo-pituitary axis resulting in cortisol production; 3) the increase in the release of catecholamines, glucagon and growth hormone; 4) decreased blood flow in muscles resulting in lower glucose uptake by muscles; 5) liver gluconeogenesis fueling the increased metabolic state [ [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] ]. The underlying pathophysiology linking hyperglycemia to COVID-19 adverse outcomes is poorly understood, including hypothetical mechanisms such as systemic inflammation resulting in insulin resistance and pancreatic beta cell infection by SARS-CoV-2 and dysfunction.…”

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confidence: 99%

SARS-CoV-2 adipose tissue infection and hyperglycemia: A further step towards the understanding of severe COVID-19

Tsilingiris

2022

Metabolism Open

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Numerous studies have highlighted the prognostic significance of hyperglycemia in the outcomes of SARS-CoV-2 infection. A number of mechanisms have been proposed as potential drivers of this association, which were, however, up until recently based rather on speculation than on investigational evidence. It has been recently come to light that the development of insulin resistance in the frame of COVID-19 is likely the driving force behind the development of overt hyperglycemia. This results through the infectious insult of the adipose tissue, and is observed in conjunction with aberrant adipokine secretion by host adipocytes, such as decreased adiponectin, as well as a switch towards an antiviral immune secretory profile. These data could have a considerable relevance not only for the management of hyperglycemia in the course of the infection but also for the overall understanding of the pathogenesis of severe COVID-19.

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Circulating leptin, soluble leptin receptor and free leptin index in critically ill patients with sepsis: a prospective observational study

Cited by 13 publications

References 37 publications

Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection?

Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection?

Circulating Chemerin and Its Kinetics May Be a Useful Diagnostic and Prognostic Biomarker in Critically Ill Patients with Sepsis: A Prospective Study

SARS-CoV-2 adipose tissue infection and hyperglycemia: A further step towards the understanding of severe COVID-19

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