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1 North Western Injury Research Centre and 2 Department of Surgery, University of Manchester, Hope Hospital, Salford M6 8HD, United Kingdom
Circulating leptin
concentrations are raised in animal models of inflammation and sepsis.
The purpose of this study was to determine the effect of sepsis on
serum leptin concentration in humans and to examine the relationship
between leptin and the metabolic consequences of sepsis. Resting energy
expenditure, insulin sensitivity, and fasting serum leptin, plasma
insulin, and cortisol concentrations were measured in 20 subjects with intra-abdominal sepsis and 20 healthy control subjects, before and
during a 2-h period of euglycemic hyperinsulinemia. Fasting serum
leptin concentrations were similar in septic and control subjects. In
simple regression analysis, serum leptin concentrations correlated
significantly with percent body fat in both septic patients
(r = 0.64, P < 0.005) and healthy subjects
(r = 0.75, P < 0.0001). Multiple regression
analyses additionally indicated that percent body fat, fasting plasma
insulin, and plasma cortisol, but not sepsis, were significant and
independent determinants of serum leptin concentration. No relationship
between leptin and resting energy expenditure or insulin sensitivity
was identifiable. A major metabolic role for leptin in human sepsis
therefore appears unlikely.
indirect calorimetry; metabolic rate; insulin; cortisol; euglycemic hyperinsulinemia
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