Diagnostic value of serum leptin and a promising novel diagnostic model for sepsis

Abstract

Diagnosis of sepsis in critically ill patients is important to reduce morbidity and mortality. The present study was conducted to determine the role of serum leptin in the early diagnosis of sepsis and to establish a diagnostic model for sepsis. A retrospective study was conducted of 331 patients from an intensive care unit. All patients underwent consistent blood collection at 6:00 a.m. every morning after fasting. Serum leptin concentrations and additional markers of sepsis were compared between the sepsis group (n=128) and the non-sepsis group (n=203). Septic patients displayed significantly higher leptin serum concentrations compared with those of the non-sepsis group (mean concentration, 11.67 versus 4.824 mg/dl; P<0.001). The leptin levels in male patients were higher than those in female patients, particularly in the sepsis group. The accuracy of serum leptin levels in distinguishing septic patients from non-septic patients was 76%, and the area under the receiver operating characteristic (ROC) curve of serum leptin was ≤0.8. Additional markers of inflammation in the sepsis group were also significantly higher than those in the non-sepsis group. Positive correlations were identified between leptin and body temperature, heart rate and creatinine levels. Therefore, a prognostic model comprising a combination of leptin with temperature, platelet count, white blood cell count and heart rate was evaluated as an effective logistic regression model for the diagnosis of sepsis. The logistic regression output cut-off value was 0.46 and the area under the ROC curve was 0.953 (P<0.0001). It may be concluded that leptin is a valuable marker in the diagnosis of sepsis and the proposed prognostic model is an effective logistic regression model for the diagnosis of sepsis. The prognostic model is able to aid the differentiation of septic patients from non-septic patients.

Endocrine dysfunction in sepsis: a beneficial or deleterious host response?

“…1,2 With an increasing incidence, severe sepsis and septic shock are major health pathogenesis of severe sepsis and septic shock has been explained by the excessive production of cytokines, endothelial activation and microvascular thrombosis. 3 The host response to infection involves a complex, organized and coherent interaction between immune, autonomic, neuroendocrine and behavioral systems.…”

Association of bone fracture type and degree of callus formation with leptin concentration in children with long bone fractures

“…Newer data demonstrated that leptin have almost of the same relevance in numerous physiological processes, such as regulation of both female and male reproduction, hematopoesis and angiogenesis, glucoregulation, wound healing, inflammation and osteogenesis (25). Furthermore, leptin has a major role in chronic inflammatory mechanism characteristic for obesity and atherosclerosis (26), sepsis (27), chronic viral infection (28) and cancer (29). Leptin exert its action by binding specific membrane receptor (Ob-R), expressed on different cell types, including immune cells (30).…”

Comparison of biomarkers adiponectin, leptin, C‐reactive protein, S100A12, and the Acute Patient Physiologic and Laboratory Evaluation (APPLE) score as mortality predictors in critically ill dogs

“…Of all the biomarkers evaluated in this study, only leptin was significantly correlated with the APPLE score, although the correlation was modest. Leptin has been used for distinguishing septic human patients from those that are nonseptic but had clinical symptoms indicative of systemic inflammatory response syndrome . The magnitude of leptin concentration is correlated to disease severity and is probably related to its inherent properties of being an inflammatory mediator.…”

“…Leptin has been used in a prognostic model in predicting sepsis in people. Leptin concentration positively correlated with body temperature, heart rate, and creatinine, and when combined with body temperature, white cell count, and heart rate, it was found to be a valuable marker for distinguishing patients that were septic from those that were nonseptic but had systemic inflammatory response syndrome . Two studies have rigorously evaluated ELISA kits for analyzing leptin and adiponectin in canine serum, respectively …”