Relationship of Plasma Leptin to Plasma Cytokines and Human Survival in Sepsis and Septic Shock

Leptin production is increased in rodents by administration of endotoxin or cytokines. To investigate whether circulating leptin is related to cytokine release and survival in human sepsis, plasma concentrations of leptin, interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, soluble TNF receptor type I, IL-1 receptor antagonist (IL-lra), and the inflammatory modulator IL-10 were measured as soon as severe sepsis (n = 28) or septic shock (n = 14) developed and every 6 h for 24 h. Patients with sepsis or septic shock had leptin concentrations 2.3- and 4.2-fold greater, respectively, than the control group. There was an independent association for leptin with IL-1ra and IL-10 in both patient groups. By discriminant analysis, leptin and IL-6 were independent predictors of death. These findings suggest that increases in leptin levels may be a host defense mechanism during sepsis.