Leptin and Iinterlukin-6 relationship and influence of mortality in sepsis

Abstract Background Sepsis is a severe and life-threatening disease involving multiple risk factors. Leptin has been suggested to play a role in modulating the inflammatory response in sepsis and improving outcomes; however, there are conflicting results regarding the outcome of sepsis. The present...

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Main Authors: Yi-Hsuan Tsai, Kai-Yin Hung, Wen-Feng Fang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10829-2
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author Yi-Hsuan Tsai
Kai-Yin Hung
Wen-Feng Fang
author_facet Yi-Hsuan Tsai
Kai-Yin Hung
Wen-Feng Fang
author_sort Yi-Hsuan Tsai
collection DOAJ
description Abstract Background Sepsis is a severe and life-threatening disease involving multiple risk factors. Leptin has been suggested to play a role in modulating the inflammatory response in sepsis and improving outcomes; however, there are conflicting results regarding the outcome of sepsis. The present study aims to clarify the expression of leptin in patients with sepsis, and its association with other cytokines. Method The retrospective study enrolled 165 adults with sepsis from medical intensive care units (ICU)s, and collected leptin, glucose levels, and cytokines such as IL-6, IL-1RA, IL-10, IL-17, TNF-α, IFN-γfor analysis. Leptin levels were divided into three groups based on concentration: Low (≤ 3.78 ng/mL), Medium (3.78 < leptin ≤ 23.2 ng/mL), and High (> 23.2 ng/mL). Survival curve analysis and comparisons among groups were performed. A subgroup analysis by sex (male and female) was also conducted. Finally, a multiple-factor logistic regression model was used to evaluate the interaction between leptin and other factors. Result The high leptin groups were the oldest (low vs. medium vs. high: 60 vs. 66 vs. 78, p < 0.0001) and had the highest body mass index (BMI) (19.8 vs. 23.9 vs. 24.2, p < 0.0001), the highest percentages of women (28.6 vs. 34.1 vs. 65.9 p = 0.001), and the most comorbidities (1 vs. 1 vs. 2, p = 0.001). After controlling IL-6, day 1 leptin had a trend associated with lower mortality in the hospital (β = 0.984, p = 0.062). The highest IL-6 group had a significantly higher mortality rate among three IL-6 level patients (p = 0.015), but in the high leptin subgroup analysis, the significant effect of high IL-6 on mortality disappeared. Besides, the subgroup analysis of men, the high leptin group had a trend of better survival than the medium and low leptin groups. Conclusion High leptin levels may mitigate the adverse prognostic impact of elevated IL-6 on septic mortality. At comparable IL-6 levels, leptin could serve as a predictor of septic outcomes. Leptin might act as a protective factor in men. Future research should explore leptin’s role in IL-6-mediated inflammation and its potential protective effect in high IL-6 sepsis cases.
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spelling doaj-art-061a91ccd9f74dfa8329c8d68d90cefa2025-08-20T01:53:23ZengBMCBMC Infectious Diseases1471-23342025-04-0125111110.1186/s12879-025-10829-2Leptin and Iinterlukin-6 relationship and influence of mortality in sepsisYi-Hsuan Tsai0Kai-Yin Hung1Wen-Feng Fang2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang GungMemorial Hospital, Chang Gung University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang GungMemorial Hospital, Chang Gung University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang GungMemorial Hospital, Chang Gung University College of MedicineAbstract Background Sepsis is a severe and life-threatening disease involving multiple risk factors. Leptin has been suggested to play a role in modulating the inflammatory response in sepsis and improving outcomes; however, there are conflicting results regarding the outcome of sepsis. The present study aims to clarify the expression of leptin in patients with sepsis, and its association with other cytokines. Method The retrospective study enrolled 165 adults with sepsis from medical intensive care units (ICU)s, and collected leptin, glucose levels, and cytokines such as IL-6, IL-1RA, IL-10, IL-17, TNF-α, IFN-γfor analysis. Leptin levels were divided into three groups based on concentration: Low (≤ 3.78 ng/mL), Medium (3.78 < leptin ≤ 23.2 ng/mL), and High (> 23.2 ng/mL). Survival curve analysis and comparisons among groups were performed. A subgroup analysis by sex (male and female) was also conducted. Finally, a multiple-factor logistic regression model was used to evaluate the interaction between leptin and other factors. Result The high leptin groups were the oldest (low vs. medium vs. high: 60 vs. 66 vs. 78, p < 0.0001) and had the highest body mass index (BMI) (19.8 vs. 23.9 vs. 24.2, p < 0.0001), the highest percentages of women (28.6 vs. 34.1 vs. 65.9 p = 0.001), and the most comorbidities (1 vs. 1 vs. 2, p = 0.001). After controlling IL-6, day 1 leptin had a trend associated with lower mortality in the hospital (β = 0.984, p = 0.062). The highest IL-6 group had a significantly higher mortality rate among three IL-6 level patients (p = 0.015), but in the high leptin subgroup analysis, the significant effect of high IL-6 on mortality disappeared. Besides, the subgroup analysis of men, the high leptin group had a trend of better survival than the medium and low leptin groups. Conclusion High leptin levels may mitigate the adverse prognostic impact of elevated IL-6 on septic mortality. At comparable IL-6 levels, leptin could serve as a predictor of septic outcomes. Leptin might act as a protective factor in men. Future research should explore leptin’s role in IL-6-mediated inflammation and its potential protective effect in high IL-6 sepsis cases.https://doi.org/10.1186/s12879-025-10829-2LeptinSepsisInterleukin 6Mortality
spellingShingle Yi-Hsuan Tsai
Kai-Yin Hung
Wen-Feng Fang
Leptin and Iinterlukin-6 relationship and influence of mortality in sepsis
BMC Infectious Diseases
Leptin
Sepsis
Interleukin 6
Mortality
title Leptin and Iinterlukin-6 relationship and influence of mortality in sepsis
title_full Leptin and Iinterlukin-6 relationship and influence of mortality in sepsis
title_fullStr Leptin and Iinterlukin-6 relationship and influence of mortality in sepsis
title_full_unstemmed Leptin and Iinterlukin-6 relationship and influence of mortality in sepsis
title_short Leptin and Iinterlukin-6 relationship and influence of mortality in sepsis
title_sort leptin and iinterlukin 6 relationship and influence of mortality in sepsis
topic Leptin
Sepsis
Interleukin 6
Mortality
url https://doi.org/10.1186/s12879-025-10829-2
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AT kaiyinhung leptinandiinterlukin6relationshipandinfluenceofmortalityinsepsis
AT wenfengfang leptinandiinterlukin6relationshipandinfluenceofmortalityinsepsis