Leptin levels after subarachnoid haemorrhage are gender dependent.

Cecilia Lindgren,Lars-Owe Koskinen,Silvana Naredi,Stefan Söderberg,Magnus Hultin

doi:10.1186/s40064-016-2321-3

Cecilia Lindgren, Lars-Owe Koskinen + Show 3 more

Open Access

https://doi.org/10.1186/s40064-016-2321-3

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Journal: SpringerPlus	Publication Date: May 27, 2016
Citations: 1	License type: CC BY 4.0

Affiliation: Umeå University, University of Gothenburg

Abstract

Background Subarachnoid hemorrhage (SAH) is a neurological disease where the majority of the patients are critically ill. The adipokine leptin has in cerebral emergencies been related to severity of disease and to adverse outcome. The aim of this study was to examine leptin levels over time after SAH and associations to gender, age, body mass index, severity of disease, parenteral lipids, systemic organ failure and outcome.MethodsProspective observational study in 56 patients. Leptin was obtained 0–240 h after SAH, in 48 h intervals. Severity of disease was assessed with the Hunt and Hess score, organ failure with the sequential organ failure assessment score, and outcome with Glasgow outcome scale. Leptin levels in the SAH group were compared with controls from the same geographical area.ResultsAt admission, Leptin was significantly higher in SAH patients compared to controls, both in female (28.6 ± 25.6 vs 13.0 ± 2.3 ng/mL, p = 0.001) and male patients (13.3 ± 8.4 vs 4.3 ± 0.7 ng/mL, p = 0.001). Leptin levels remained stable over time. Female patients had significantly higher leptin levels than male patients, and deceased female patients had higher leptin levels than female survivors (85.5 ± 20.5 vs 50.5 ± 34.6, n = 4/35, p < 0.05). Leptin levels did not differ between male survivors and non-survivors. Leptin levels were not associated with severity of disease, organ failure or parenteral lipids.ConclusionLeptin levels were significantly higher in both male and female patients compared to controls. Higher leptin levels were related to outcome and organ failure in women but not in men. When analysing leptin levels gender-related differences should be considered.

Highlights

Subarachnoid hemorrhage (SAH) is a neurological disease where the majority of the patients are criti‐ cally ill
The aim of this study was to examine if leptin levels change over time in the acute phase of SAH and if the leptin levels were associated with gender, age, body mass index (BMI), severity of disease, administration of parenteral lipids, systemic organ failure and outcome
Inclusion criteria were; SAH caused by a cerebral aneurysm, verified by digital subtraction angiography (DSA) or CT angiography (CTA), age ≥ 18 years, and arrival at Umeå University hospital (UUH) ≤ 48 h after the first symptom of SAH that brought the patient to hospital

Summary

Introduction

Subarachnoid hemorrhage (SAH) is a neurological disease where the majority of the patients are criti‐ cally ill. The SAH produces an initial global ischemic brain injury that stimulates the sympathetic nervous system and starts an inflammatory process (Zetterling et al 2010; Naredi et al 2000). This inflammatory process affects the brain and gives rise to a systemic inflammatory response syndrome (SIRS), with release of inflammatory mediators. Studies in critically ill patients have shown variations in leptin levels and both normal and elevated leptin levels have been reported to correlate to inflammatory markers, body temperature and cortisol levels (Bornstein et al 1998; Papathanassoglou et al 2001; Koch et al 2010; Chen et al 2014; Grigoras et al 2014; Yousef et al 2010)

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