leptin and Tuberculosis--Pulmonary

Malnutrition is a prominent feature of tuberculosis. Little is known about the role of the appetite-related hormones, ghrelin and leptin, in malnutrition in tuberculosis. This study was undertaken to determine whether ghrelin and leptin contribute to malnutrition in active pulmonary tuberculosis.. Nutritional parameters and plasma levels of ghrelin, leptin, and inflammatory cytokines were measured before treatment and after clinical improvement following anti-tuberculosis chemotherapy in 23 tuberculosis subjects and 23 healthy controls prospectively. Patients were divided into well-nourished (n=15) and malnourished (n=8) groups.. Ghrelin but not leptin levels were significantly lower in the malnourished tuberculosis group than in the well-nourished tuberculosis group [44.0 (43.0-54.0) vs. 122 (108-158)pg/mL; p<0.05]. Malnutrition score was negatively correlated to ghrelin (rho=-0.76, p<0.01) but not to leptin levels. TNF-alpha and IL-6 levels were significantly higher in the malnourished tuberculosis group than in the well-nourished tuberculosis group and controls. Plasma levels of ghrelin tended to decrease as inflammatory cytokines increased before treatment.. Decreased plasma ghrelin levels, in addition to increased plasma inflammatory cytokine levels, may be associated with malnutrition in active pulmonary tuberculosis.

Topics: Adult; Aged; Aged, 80 and over; Antitubercular Agents; Biomarkers; C-Reactive Protein; Female; Ghrelin; Humans; Inflammation Mediators; Interleukin-6; Leptin; Male; Malnutrition; Middle Aged; Mycobacterium tuberculosis; Nutrition Assessment; Nutritional Status; Severity of Illness Index; Sputum; Tuberculosis, Pulmonary; Tumor Necrosis Factor-alpha; Young Adult

The aim of our study was to investigate the association of leptin (LEP) gene (rs11761556, rs12706832, rs2167270), leptin receptor (LEPR) gene (rs1137100, rs1137101, rs1805096) variants and pulmonary tuberculosis (PTB) susceptibility, as well as their several clinical manifestations, in a Chinese population.. This study included a cohort of 489 PTB patients and 489 healthy controls, and six SNPs were genotyped by improved multiple ligase detection reaction (iMLDR).. We found that there were no significant differences regarding the allele and genotype frequencies of LEP rs11761556, rs12706832, rs2167270, LEPR rs1137100, rs1137101, rs1805096 between PTB patients and healthy controls (all P > 0.05), as well as the results of the dominant model and recessive model (all P > 0.05). In the LEP gene, the rs11761556 AA genotype frequency was significantly associated with the development of fever and pulmonary infection in PTB patients (P = 0.035, P = 0.049). In addition, the relation between main haplotypes and PTB patients was also analyzed, but only haplotype CAG in LEP was significantly associated with PTB susceptibility (P = 0.012).. LEP and LEPR heritable variation were not contribute to the pathogenesis of PTB in Chinese. While rs11761556 variant might associate with several clinical features of PTB.

Topics: Case-Control Studies; China; Gene Frequency; Genetic Predisposition to Disease; Genotype; Humans; Leptin; Polymorphism, Single Nucleotide; Receptors, Leptin; Tuberculosis, Pulmonary

Vitamin D deficiency (VDD) is common in tuberculosis (TB) and may be implicated in the etiology of the disease and in its clinical course. The aim of this study was to investigate the association between leptin, inflammatory markers and VD status in TB patients, stratified for presence or absence of diabetes mellitus (DM). Two hundred ninety-nine TB patients were recruited from October 2015 to August 2016. Also, 91 normal controls were included. The information including socio-demographics, dietary intake and living habits was obtained by face-to-face interview. Serum concentrations of leptin and TNF-α, CRP and IL-6 were compared between TB patients with and without severe VDD (SVDD). Pearson's correlation was used to analyze the association between TNF-α, leptin and 25-hydroxyvitamin D (25(OH)D). A significantly higher prevalence of VDD and SVDD was observed in TB patients compared with normal controls (93.0% vs 70.3%, 65.9% vs 3.3% respectively). Concentration of leptin was significantly lower, while TNF-α higher in TB patients with SVDD compared to those without (p<0.05). After adjustment for confounders, leptin was positively associated with 25(OH)D (r=0.210, p=0.002) with similar correlation in TB patients with DM (r=0.240, p=0.020). A negative association between TNF-α and 25(OH)D was observed (r=-0.197, p=0.003), which was significant only in the subgroup without DM (r=-0.304, p=0.001). Our findings indicate that a higher VD status in TB patients may be related to higher immune activity and less serious tissue damage, and that this relation is different according to presence or absence of DM co-morbidity.

Topics: Adolescent; Adult; Aged; C-Reactive Protein; Cross-Sectional Studies; Female; Humans; Interleukin-6; Leptin; Male; Middle Aged; Nutritional Status; Prevalence; Tuberculosis, Pulmonary; Tumor Necrosis Factor-alpha; Vitamin D; Vitamin D Deficiency; Young Adult

Muscle weakness is a part of the wasting syndrome associated with TB. Cytokines are candidates as the initial causative agents of the metabolic changes in TB. The objective of this study is to assess the peripheral and respiratory muscle strength in patients with TB and controls and relate these findings with leptin, IL-6 and TNF-α serum levels.. Case-control study. Hospitalized patients with pulmonary TB and controls were included. Maximal voluntary handgrip strength (HS), maximal inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were measured. Leptin, IL-6 and TNF-α dosage were performed.. We included 35 cases and 35 controls. Leptin was lower and TNF-α levels were higher in TB patients than in controls (P < .0001 for both). Body mass index (BMI), HS, MIP and MEP were all significantly lower in cases than in controls (P < .0001). Lower leptin and higher TNF-α levels are associated with malnutrition and reduced MIP, MEP and HS. Patients who reported fever and those with positive culture for Mycobacterium tuberculosis had higher serum levels of IL-6.. Peripheral and respiratory muscle strength and leptin levels were reduced in patients with active TB. Lower levels of leptin and higher levels of TNF-α were associated with malnutrition and with reduced MIP, MEP and HS.

Topics: Adult; Biomarkers; Body Mass Index; Brazil; Case-Control Studies; Cytokines; Female; Hand Strength; Humans; Interleukin-6; Leptin; Male; Maximal Respiratory Pressures; Middle Aged; Muscle Strength; Prospective Studies; Respiratory Muscles; Tuberculosis, Pulmonary; Tumor Necrosis Factor-alpha

Pulmonary tuberculosis (PTB) is associated with modulation of levels of adipokines, specifically adiponectin and leptin, but the effect of standard antituberculosis treatment (ATT) on the systemic levels of adiponectin, resistin, and leptin has not been well explored. To identify the association of adipokines with PTB and their relationship with disease severity and bacterial burden, we measured the levels of adiponectin, resistin, and leptin in PTB individuals and compared them with latent tuberculosis (LTB) and healthy control (HC) individuals. Pulmonary tuberculosis was characterized by diminished circulating levels of adiponectin and leptin and heightened circulating levels of resistin in comparison to that in LTB and HC individuals. However, PTB with bilateral or cavitary disease did not exhibit any increased systemic levels of these adipokines in comparison with those with unilateral or non-cavitary disease, respectively. In addition, none of the adipokines exhibited a positive correlation with bacterial burdens, but adiponectin alone exhibited a negative correlation with body mass index in PTB individuals. Finally, on successful completion of ATT, PTB individuals exhibited significantly increased levels of adiponectin and leptin and significantly decreased levels of resistin. Therefore, our data identify an important association of systemic adipokine levels with PTB disease and its alteration following ATT.

Topics: Adiponectin; Adult; Aged; Antitubercular Agents; Bacterial Load; Body Mass Index; Case-Control Studies; Female; Gene Expression; Humans; Latent Tuberculosis; Leptin; Male; Middle Aged; Mycobacterium tuberculosis; Resistin; Severity of Illness Index; Tuberculosis, Pulmonary

Patients with distinctive morphotype were more susceptible to nontuberculous mycobacterial lung disease (NTM-LD). However, little is known about the association between body morphotype and progression of NTM-LD. The aim of this study was to elucidate predictors of NTM-LD progression, focusing on body morphotype and composition.. Data from patients with NTM-LD who participated in NTM cohort which started in 1 July 2011 were analyzed. Patients with more than 6 months of follow up were included for analysis. NTM-LD progression was defined as clinician-initiated anti-NTM treatment, based on symptomatic and radiologic aggravation. Body morphotype and composition was measured at entry to the cohort using bioelectrical impedance analysis.. NTM-LD progressed in 47 out of 150 patients with more than 6 months of follow up. Patients with middle (adjusted hazard ratio [aHR], 2.758; 95% confidence interval [CI], 1.112-6.843) or lowest tertile (aHR, 3.084; 95% CI, 1.241-7.668) of abdominal fat ratio had a higher risk of disease progression compared with the highest tertile. Other predictors for disease progression were presence of cavity on chest computed tomography (aHR, 4.577; 95% CI, 2.364-8.861), and serum albumin level <3.5 g/dL (aHR, 12.943; 95% CI, 2.588-64.718).. Progression of NTM-LD is associated with body composition. Lower abdominal fat ratio is an independent predictor of NTM-LD progression.. ClinicalTrials.gov, NCT01616745 Registered 25 March 2012.

Topics: Abdominal Fat; Adiposity; Aged; Anthropometry; Disease Progression; Female; Humans; Leptin; Logistic Models; Lung; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Proportional Hazards Models; Prospective Studies; Republic of Korea; Sputum; Tomography, X-Ray Computed; Tuberculosis, Pulmonary

Type 2 diabetes mellitus (T2DM) is recognized as major risk factor for the progress of active pulmonary tuberculosis (PTB), although the mechanistic link between diabetes and tuberculosis remains poorly characterized. Moreover, the influence of poorly controlled diabetes on the baseline levels of adipocytokines in the context of tuberculosis has not been explored in detail. To characterize the influence of coexistent DM on adipocytokine levels in pulmonary or latent TB (LTB), we examined circulating levels of adipocytokines in the plasma of individuals with PTB-DM or LTB-DM and compared them with those without DM (PTB or LTB). PTB-DM or LTB-DM is characterized by diminished circulating levels of adiponectin and adipsin and/or heightened circulating levels of leptin, visfatin and PAI-1. In addition, adiponectin and adipsin exhibit a significant negative correlation, whereas leptin, visfatin and PAI-1 display a significant positive correlation with HbA1C levels and random blood glucose levels. Therefore, our data reveal that PTB-DM or LTB-DM is characterized by alterations in the systemic levels of adipocytokines, indicating that altered adipose tissue inflammation underlying Type 2 diabetes potentially contributes to pathogenesis of TB disease.

Topics: Adipokines; Adiponectin; Adipose Tissue; Adult; Aged; Blood Glucose; Complement Factor D; Cytokines; Diabetes Mellitus, Type 2; Female; Glycated Hemoglobin; Humans; Inflammation; Latent Tuberculosis; Leptin; Male; Middle Aged; Mycobacterium tuberculosis; Nicotinamide Phosphoribosyltransferase; Plasminogen Activator Inhibitor 1; Tuberculosis, Pulmonary

Pulmonary tuberculosis (TB) patients often suffer from anorexia and poor nutrition, causing weight loss. The peptide hormones leptin and its counterpart ghrelin, acting in the regulation of food intake and fat utilization, play an important role in nutritional balance. This study aimed to investigate the association of blood concentrations of leptin, ghrelin and inflammatory cytokines with body mass index (BMI) in TB patients with and without type 2 diabetes mellitus (T2DM).. BMI, biochemical parameters and plasma levels of leptin, ghrelin and inflammatory cytokines were measured before the start of treatment in 27 incident TB patients with T2DM, 21 TB patients and 23 healthy subjects enrolled in this study.. The levels of leptin were significantly higher in TB patients (35.2 ± 19.1 ng/ml) than TB+T2DM (12.6 ± 6.1 ng/ml) and control (16.1 ± 11.1 ng/ml) groups. The level of ghrelin was significantly lower in TB (119.9 ± 46.1 pg/ml) and non-significantly lower in TB+T2DM (127.7 ± 38.6 pg/ml) groups than control (191.6 ± 86.5 pg/ml) group. The levels of TNF-α were higher, while IFN-γ and IL-6 levels were lower in patients than in the control group. Leptin showed a negative correlation with BMI in TB (r=-0.622, p<0.05) and TB+T2DM (r= -0.654, p<0.05) groups, but a positive correlation with BMI in the control group (r=0.521, p<0.05). Contrary ghrelin showed a positive correlation with BMI in TB (r=0.695, p<0.05) and TB+T2DM (r= 0.199, p>0.05) groups, but negative correlation with BMI in the control (r=-0.693, p<0.05) group. Inflammatory cytokines were poorly correlated with BMI in this study. Only IFN-γ showed a significant negative correlation with BMI in the control group (r=-0.545, p<0.05).. This study may suggest that possible abnormalities in ghrelin and leptin regulation (high levels of leptin and low levels of ghrelin) may be associated with low BMI and may account for the poor nutrition associated with TB and TB+T2DM.

Topics: Body Mass Index; Diabetes Mellitus, Type 2; Female; Ghrelin; Humans; Inflammation; Interferon-gamma; Interleukin-6; Leptin; Male; Middle Aged; Tuberculosis, Pulmonary; Tumor Necrosis Factor-alpha

Wasting is known as a prominent feature of tuberculosis (TB). To monitor the disease state, markers of metabolism and inflammation are potentially useful. We thus analyzed two major adipokines, adiponectin and leptin, and two other metabolic markers, fetuin-A and retinol-binding protein 4 (RBP4).. The plasma levels of these markers were measured using enzyme-linked immunosorbent assays in 84 apparently healthy individuals (=no-symptom group) and 46 patients with active pulmonary TB around the time of treatment, including at the midpoint evaluation (=active-disease group) and compared them with body mass index (BMI), C-reactive protein (CRP), chest radiographs and TB-antigen specific response by interferon-γ release assay (IGRA).. In the no-symptom group, adiponectin and leptin showed negative and positive correlation with BMI respectively. In the active-disease group, at the time of diagnosis, leptin, fetuin-A and RBP4 levels were lower than in the no-symptom group [adjusted means 2.01 versus 4.50 ng/ml, P<0.0001; 185.58 versus 252.27 µg/ml, P<0.0001; 23.88 versus 43.79 µg/ml, P<0.0001, respectively]. High adiponectin and low leptin levels were associated with large infiltrates on chest radiographs even after adjustment for BMI and other covariates (P=0.0033 and P=0.0020). During treatment, adiponectin levels increased further and then decreased. Leptin levels remained low. Initial low levels of fetuin-A and RBP4 almost returned to the normal reference range in concert with reduced CRP.. Our data and recent literature suggest that low fat store and underlying inflammation may regulate these metabolic markers in TB in a different way. Decreased leptin, increased adiponectin, or this ratio may be a promising marker for severity of the disease independent of BMI. We should further investigate pathological roles of the balance between these adipokines.

Topics: Adiponectin; Adult; alpha-2-HS-Glycoprotein; Analysis of Variance; Biomarkers; Body Mass Index; C-Reactive Protein; Enzyme-Linked Immunosorbent Assay; Female; Humans; Inflammation; Leptin; Male; Middle Aged; Retinol-Binding Proteins, Plasma; Tuberculosis, Pulmonary

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.

Topics: Adult; Antitubercular Agents; Body Mass Index; Female; Humans; Immunoassay; Leptin; Male; Middle Aged; Tuberculosis, Pulmonary; Tumor Necrosis Factor-alpha

Wasting is a prominent feature of tuberculosis and may be more severe among individuals with HIV coinfection. It is likely that several biological mechanisms, including the anorexia of infection, are contributing to wasting.. The purpose of this study was to determine whether leptin concentrations, in relation to the inflammatory cytokine response and level of HIV infection, are contributing to loss of appetite and wasting in adults with pulmonary tuberculosis and HIV infection.. We characterized plasma leptin concentrations in relationship with self-reported loss of appetite, body mass index, fat mass (FM), IL-6, and HIV load in a cross-sectional study of 500 adults who presented with pulmonary tuberculosis in Zomba, Malawi.. Plasma leptin concentrations, associated with FM, significantly decreased by increasing tertile of plasma HIV load (P = 0.0001). Leptin concentrations were inversely associated with plasma IL-6 concentrations after adjusting for sex, age, FM, and HIV load. Plasma leptin concentrations were associated with neither loss of appetite nor wasting. Inflammation, reflected by increased IL-6 concentrations, was associated with loss of appetite (odds ratio, 3.41; 95% confidence interval, 1.91-6.09), when adjusted for sex, age, FM, leptin concentrations, and HIV load. A high plasma HIV load was associated with severe wasting, defined as body mass index less than 16.0 kg/m2 (odds ratio, 2.14; 95% confidence interval, 1.09-4.19) when adjusted for sex, age, IL-6, FM, and leptin concentrations.. This study suggests that the anorexia and wasting seem primarily determined by the level of inflammation and the level of HIV infection in patients with tuberculosis and HIV coinfection.

Topics: Adult; Anorexia; Appetite; Biomarkers; Body Mass Index; Cross-Sectional Studies; Female; HIV Wasting Syndrome; Humans; Interleukin-6; Leptin; Malawi; Male; Predictive Value of Tests; Tuberculosis, Pulmonary; Viral Load

The development of active tuberculosis after infection with Mycobacterium tuberculosis is almost invariably caused by a persistent or transient state of relative immunodeficiency. Leptin, the product of the obese (ob) gene, is a pleiotropic protein produced mainly by adipocytes and is down-regulated during malnutrition and starvation, conditions closely connected with active tuberculosis. To investigate the role of leptin in tuberculosis, we intranasally infected wild-type (Wt) and leptin-deficient ob/ob mice with live virulent M. tuberculosis. Ob/ob mice displayed higher mycobacterial loads in the lungs after 5 and 10 weeks of infection, although the difference with Wt mice remained 1 log of M. tuberculosis colony forming unit. Nevertheless, ob/ob mice were less able to form well-shaped granuloma and lung lymphocyte numbers were reduced compared with Wt mice early during infection. In addition, ob/ob mice had a reduced capacity to produce the protective cytokine IFNgamma at the site of the infection early during infection and upon antigen-specific recall stimulation, and showed reduced delayed-type hypersensitivity reaction to intra-dermal tuberculin purified protein derivative. Leptin replacement restored the reduced IFNgamma response observed in ob/ob mice. Mortality did not differ between ob/ob and Wt mice. These data suggest that leptin plays a role in the early immune response to pulmonary tuberculosis.

Topics: Animals; Gene Expression Regulation; Granuloma, Respiratory Tract; Interferon-gamma; Leptin; Mice; Mice, Obese; Mycobacterium tuberculosis; Tuberculosis, Pulmonary

Pulmonary tuberculosis is the classic cause of "consumption," but the pathogenesis of such wasting is largely unknown. Animal studies in other conditions suggest that leptin may be a mediator between proinflammatory cytokine activity and wasting.. We tested whether the leptin concentration, after control for body fat mass, is higher during active pulmonary tuberculosis than after recovery and whether it correlates with energy metabolism and proinflammatory cytokine activity.. Nondiabetic adults with pulmonary tuberculosis (n = 32) were recruited into a prospective observational study. Patients found to be antibody positive for human immunodeficiency virus were excluded from the study. Dual-energy X-ray absorptiometry, indirect calorimetry, and food intake protocols were performed at baseline and after 1 and 6 mo of tuberculosis treatment. Fasting plasma leptin, tumor necrosis factor alpha and its soluble receptor, and interleukin 6 were measured by enzyme-linked immunosorbent assay.. Resting energy expenditure was close to Harris-Benedict predictions and did not change significantly during treatment, but energy intake increased. Leptin concentration was correlated in a log-linear fashion with percentage body fat but was independent of cytokines and energy intake. There was no significant difference in leptin, corrected for energy balance and fat mass, at baseline and after 1 and 6 mo of treatment.. These data are compatible with recovery from anorexia or starvation without discernible hyper- or hypometabolism. The close correlation of leptin with body fat mass is similar to observations in healthy subjects. No additional influence of disease state or proinflammatory cytokine activity was found. Leptin does not appear to be a component of the immune response to human pulmonary tuberculosis, and thus it cannot account for the weight loss and anorexia associated with tuberculosis.

Topics: Absorptiometry, Photon; Adipose Tissue; Adolescent; Adult; Aged; Aged, 80 and over; Body Composition; Body Water; Calorimetry, Indirect; Chronic Disease; Cytokines; Energy Intake; Energy Metabolism; Enzyme-Linked Immunosorbent Assay; Female; Humans; Leptin; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Tuberculosis, Pulmonary; Weight Loss

The relationship of leptin to diminished appetite and weight loss has been investigated in many diseases. Diminished appetite and weight loss are the most apparent characteristics of patients with active lung tuberculosis and in this study the relation of leptin to such diminished appetite and weight loss has been investigated in patients with active lung tuberculosis before and after treatment. Twenty-five patients (7 female, 18 male) with active tuberculosis having an age range of 18-70 years (mean 47.48 +/- 15.36 y) and 25 normal individuals (9 female, 16 male) having an age range of 25-71 years (mean 44.60 +/- 13.80 y) were included in this study. Leptin levels, body mass index (BMI), body fat ratio (BFR), and waist hip ratio (WHR) were measured before and after 6 months of antituberculosis treatment. The same measurements were also made in the control group and the results were compared. While the pretreatment BMI (22.02 +/- 4.31 kg/m2) and BFR (16.60% +/- 9.30%) values in the patient group were significantly lower than in the control group, we found no difference in their pretreatment WHR values. Pretreatment leptin levels (3.49 +/- 3.34 microg/L) were significantly higher in patients with tuberculosis than in the control group (2.33 +/- 1.10 microg/L). Leptin levels were found to be significantly increased at the 6th month of antituberculosis treatment (5.65 +/- 5.41 microg/L) than the pretreatment values (p < 0.05). We observed an evident increase in BMI (24.10 +/- 4.87 kg/m2) and BFR (17.51% +/- 9.25%) due to antituberculosis treatment (p < 0.05). This study suggests that leptin has a role in the diminished appetite and weight loss symptoms in patients with active lung tuberculosis.

Topics: Adipose Tissue; Adolescent; Adult; Aged; Antibiotics, Antitubercular; Body Composition; Body Constitution; Body Mass Index; Female; Humans; Leptin; Male; Middle Aged; Regression Analysis; Tuberculosis, Pulmonary

In this study we investigated whether leptin and TNFalpha levels change with improvement in body weight with antituberculotic therapy in active tuberculosis patients. 30 patients (8 females and 22 males) with active pulmonary tuberculosis formed the patient group, and 25 sex- and age-matched healthy subjects (8 females and 17 males) served as the control group. Body weight, body mass index (BMI) and serum leptin and plasma TNFalpha levels are measured before and in the sixth month of therapy in all patients. Before the initiation of therapy, BMI of the patients was significantly lower than BMI of the controls (20.2 +/- 1.6 vs. 25.2 +/- 2.7 kg/m(2), respectively; p < 0.05). After treatment, BMI of the patients increased significantly to 21.4 +/- 1.9 kg/m(2) (p < 0.05), but was still lower than that of the controls (p < 0.05). Pretreatment serum leptin (4.5 +/- 0.9 vs. 2.1 +/- 0.2 ng/ml, respectively; p < 0.05) and plasma TNFalpha (27.9 +/- 3.4 vs. 23.9 +/- 3.0 pg/ml, respectively; p < 0.05) levels of the patients were significantly higher than those of the controls. After treatment, serum leptin levels increased to 6.7 +/- 2.2 ng/ml, but this rise was not statistically significant (p > 0.05). Treatment did not result in any significant change in TNFalpha levels, either. Delta leptin was highly related to Delta BMI in patients with tuberculosis (r = 0.68, p = 0.02). In the pretreatment period, there was a significant correlation between leptin and TNFalpha levels in the whole patient group (r = 0.78, p < 0.001), and in female (r = 0.74, p < 0.001) and male patients separately (r = 0.74, p = 0.035). In conclusion, leptin and TNFalpha may be responsible for the weight loss in pulmonary tuberculosis patients, but their levels do not change with improvement in body weight with antituberculotic treatment.

Topics: Adult; Antibiotics, Antitubercular; Antitubercular Agents; Body Mass Index; Body Weight; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Leptin; Male; Middle Aged; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary; Tumor Necrosis Factor-alpha