Relation of Leptin and Tumor Necrosis Factor α to Body Weight Changes in Patients with Pulmonary Tuberculosis

Abstract

In this study we investigated whether leptin and TNFα levels change with improvement in body weight with antituberculotic therapy in active tuberculosis patients. 30 patients (8 females and 22 males) with active pulmonary tuberculosis formed the patient group, and 25 sex- and age-matched healthy subjects (8 females and 17 males) served as the control group. Body weight, body mass index (BMI) and serum leptin and plasma TNFα levels are measured before and in the sixth month of therapy in all patients. Before the initiation of therapy, BMI of the patients was significantly lower than BMI of the controls (20.2 ± 1.6 vs. 25.2 ± 2.7 kg/m², respectively; p < 0.05). After treatment, BMI of the patients increased significantly to 21.4 ± 1.9 kg/m² (p < 0.05), but was still lower than that of the controls (p < 0.05). Pretreatment serum leptin (4.5 ± 0.9 vs. 2.1 ± 0.2 ng/ml, respectively; p < 0.05) and plasma TNFα (27.9 ± 3.4 vs. 23.9 ± 3.0 pg/ml, respectively; p < 0.05) levels of the patients were significantly higher than those of the controls. After treatment, serum leptin levels increased to 6.7 ± 2.2 ng/ml, but this rise was not statistically significant (p > 0.05). Treatment did not result in any significant change in TNFα levels, either. Δ leptin was highly related to Δ BMI in patients with tuberculosis (r = 0.68, p = 0.02). In the pretreatment period, there was a significant correlation between leptin and TNFα levels in the whole patient group (r = 0.78, p < 0.001), and in female (r = 0.74, p < 0.001) and male patients separately (r = 0.74, p = 0.035). In conclusion, leptin and TNFα may be responsible for the weight loss in pulmonary tuberculosis patients, but their levels do not change with improvement in body weight with antituberculotic treatment.

Leptin Levels in Various Manifestations of Pulmonary Tuberculosis

“…However, in chronic inflammatory and infectious diseases such as AIDS, rheumatoid arthritis, and inflammatory bowel disease, no changes in leptin levels have been observed [20–22]. Çakir et al [23] have found increased levels of TNF- α and leptin in tuberculosis patients with good correlation of these two parameters and interpreted that the eleveted leptin level leads to weight loss, and may therefore contribute to the inflammatory process. Conversely, we found reduced leptin levels in TB patients both before and after the treatment.…”

“…Conflicting data have been reported for leptin levels during infection. Eleveted leptin levels were detected in the studies published by Çakir et al [23] and Yüksel et al [30]. On the other hand, Van Crevel et al [24] have shown that both plasma leptin and ex vivo IFN-gamma production were low and increased upon successful antituberculous treatment.…”

Malnutrition and Infection: Complex Mechanisms and Global Impacts

“…Active tuberculosis is associated with cachexia, weight loss, and low serum concentrations of leptin [41–44]. Moreover, leptin-deficient mice are more susceptible to M.…”

The role of leptin in the respiratory system: an overview

“…However, the reduction of leptin levels may represent a protective component of the immune response in pulmonary TB [159]. The previous findings are not replicated in two studies, which report higher leptin concentrations in patients with active pulmonary TB versus controls [163,164]. …”