Buyukoglan Hakan, Gulmez Inci, Kelestimur Fahrettin, Kart Levent, Oymak F Sema, Demir Ramazan, Ozesmi Mustafa
Department of Pulmonology, Faculty of Medicine, Erciyes University, 38200 Kayseri, Turkey.
Mediators Inflamm. 2007;2007:64859. doi: 10.1155/2007/64859. Epub 2007 Jan 4.
Proinflammatory cytokines are prime candidates as causative agents of the metabolic changes that eventually result in tuberculosis-associated weight loss. Microbial products and cytokines such as TNF and IL-1 increase leptin expression dose dependently in adipose tissue. Leptin plays an important role in cellular immunity.
In this study, we investigated serum leptin and TNF-alpha levels before and after antituberculosis therapy in patients with active pulmonary tuberculosis (TB).
Twenty five in patients with active pulmonary TB and 18 healthy controls participated in the study. Leptin and TNF-alpha levels were measured before treatment and six months after the treatment and they were compared with the control group. Body mass index (BMI) and chest X-rays before and after the treatment were also evaluated.
The leptin levels before and after the treatment were 1.66+/-1.68 ng/mL and 3.26+/-3.81 ng/mL, respectively. The leptin levels of tuberculous patients were significant than in healthy patients (P < .05). The BMI was 19.36+/-2.55 kg/m2 before the treatment and 22.87+/-3.13 kg/m2 after the treatment. The TNF-alpha level was 23.19+/-12.78 pg/mL before the treatment and 15.95+/-6.58 pg/mL after the treatment. There was no correlation between leptin and TNF-alpha levels. Leptin levels were low in patients who had sequela lesion on chest radiographs.
Leptin levels are suppressed in tuberculous patients and low leptin levels may contribute to increased susceptibility to infection and recovery with sequela lesions.
促炎细胞因子是导致最终引起结核病相关体重减轻的代谢变化的主要候选致病因素。微生物产物以及诸如肿瘤坏死因子（TNF）和白细胞介素-1（IL-1）等细胞因子可在脂肪组织中剂量依赖性地增加瘦素表达。瘦素在细胞免疫中发挥重要作用。
在本研究中，我们调查了活动性肺结核（TB）患者抗结核治疗前后的血清瘦素和肿瘤坏死因子-α（TNF-α）水平。
25例活动性肺结核患者和18名健康对照者参与了本研究。在治疗前和治疗6个月后测量瘦素和TNF-α水平，并与对照组进行比较。还评估了治疗前后的体重指数（BMI）和胸部X光片。
治疗前后的瘦素水平分别为1.66±1.68 ng/mL和3.26±3.81 ng/mL。结核病患者的瘦素水平显著高于健康患者（P < 0.05）。治疗前BMI为19.36±2.55 kg/m²，治疗后为22.87±3.13 kg/m²。治疗前TNF-α水平为23.19±12.78 pg/mL，治疗后为15.95±6.58 pg/mL。瘦素和TNF-α水平之间无相关性。胸部X光片有后遗症病变的患者瘦素水平较低。
结核病患者的瘦素水平受到抑制，低瘦素水平可能导致感染易感性增加以及出现后遗症病变后恢复缓慢。
