Odlisná dynamika leptinu a kortizolu v průbĕhu neinfekcní stresové odpovĕdi
[Differences in the dynamics of leptin and cortisol during the non-infectious stress reaction]
Language Czech Country Czech Republic Media print
Document type English Abstract, Journal Article
PubMed
12448201
- MeSH
- Adrenocorticotropic Hormone blood MeSH
- alpha 1-Antitrypsin analysis MeSH
- C-Reactive Protein analysis MeSH
- Surgical Procedures, Operative adverse effects MeSH
- Adult MeSH
- Stress, Physiological blood etiology MeSH
- Gastroplasty MeSH
- Hydrocortisone blood MeSH
- Colorectal Neoplasms surgery MeSH
- Leptin blood MeSH
- Middle Aged MeSH
- Humans MeSH
- Acute-Phase Reaction blood etiology MeSH
- Aged MeSH
- Sepsis blood MeSH
- Tumor Necrosis Factor-alpha analysis MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- English Abstract MeSH
- Journal Article MeSH
- Names of Substances
- Adrenocorticotropic Hormone MeSH
- alpha 1-Antitrypsin MeSH
- C-Reactive Protein MeSH
- Hydrocortisone MeSH
- Leptin MeSH
- Tumor Necrosis Factor-alpha MeSH
UNLABELLED: Leptin is a hormone and acute phase reactant with multiple effects during both rest and inflammatory period. Effects of leptin in acute phase response cover a modulation of hypothalamo-pituitoadrenal (HPA) axis, too. In our study we evaluate the dynamics of leptin and glucocorticoid acute changes in model situations of infectious and non-infectious inflammatory reaction. PATIENTS AND METHODS: This study was realized on a group of patients 1--after operation of carcinoma coli (16 persons), 2--after laparoscopic non-adjustable gastric banding (13 persons), and patients 3--with development of postoperative intraabdominal sepsis (22 persons). Plasma levels of leptin, ACTH, cortisol, TNF-alpha, IL-6, C reactive protein (CRP), and alpha1-antitrypsin (AAT) were measured from -7 to +3 day related to surgery or 2nd day after a day when signs of sepsis were occurred. RESULTS: All tested parameters responded to surgical trauma with elevation 12 h after operation except leptin that elevated +24 h after surgery. Maximal levels of measured parameters were found 12 h after surgery (for cortisol), 24 h after surgery (for leptin, TNF-alpha, IL-6), or 36 h after operation (for CRP and AAT). Maximal levels of cortisol after a resection of coli or maximal levels of leptin after laparoscopic gastric banding fall to septic range. Other parameters in uncomplicated postoperative period significantly differed from septic levels on p < 0.01. There wasn't found statistically significant correlation between leptin and cortisol or between leptin and ACTH in all groups. DISCUSSION AND CONCLUSION: The elevation of leptin in postoperative period and during sepsis reflects a different regulation of this protein in rest period and during systemic inflammatory response. The inhibitory effect of leptin to HPA axis during stress response was documented in vitro, however, its physiological importance is not clear, yet. Our study didn't prove a statistically significant relation between plasma cortisol and leptin. The different dynamics of leptin and cortisol after surgical trauma shows that both factors have own specific regulation.
