Tetraplegic subjects have hyperleptinaemia with marked circadian variation.

Abstract:

OBJECTIVE:The disruption between the brain and the spinal cord leads to a decentralized sympathetic nervous system in people with chronic, cervical spinal cord lesions. These tetraplegic subjects are prone to disorders of energy metabolism and osteoporosis, and they experience alterations in their body composition with a relative accumulation of fat. The adipocyte-derived cytokine leptin is a key signal in caloric intake and energy expenditure, and it might modify bone remodelling, possibly regulated by sympathetic neuronal signalling. In able-bodied subjects leptin exhibits circadian variations, possibly mediated via sympathetic neurones. We have examined the plasma concentration of leptin among tetraplegics, to determine whether plasma leptin in these subjects exhibits circadian variations. MEASUREMENTS AND RESULTS:Blood samples were collected during a 24-h study period from tetraplegic subjects (n = 6) and from able-bodied controls (n = 8). Fasting, tetraplegic subjects had mean plasma concentrations of leptin about four times those of able-bodied controls (P < 0.05). In tetraplegia, plasma leptin was negatively correlated with total lean mass (r =-0.88, P < 0.05) but correlated positively with total fat mass (r = 0.89, P < 0.05). A marked circadian variation in plasma leptin concentrations was more evident in tetraplegia than in able-bodied controls. CONCLUSION:Plasma leptin is markedly elevated and it shows more prominent circadian variations in tetraplegia compared with able-bodied subjects. Possibly the regulation of leptin metabolism is impaired among these patients. This might distort thermogenesis and energy expenditure, thus explaining the enhanced risk of the metabolic syndrome and of osteoporosis among tetraplegic subjects.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Hjeltnes N,De Groot P,Birkeland KI,Falch JA,Iversen PO

doi

10.1111/j.1365-2265.2005.02204.x

keywords:

subject

Has Abstract

pub_date

2005-02-01 00:00:00

pages

223-7

issue

2

eissn

0300-0664

issn

1365-2265

pii

CEN2204

journal_volume

62

pub_type

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