DOI QR코드

DOI QR Code

Effect of tuberculosis treatment on leptin levels, weight gain, and percentage body fat in Indonesian children

  • Mexitalia, Maria (Department of Pediatrics, Faculty of Medicine, Diponegoro University, Dr. Kariadi Hospital) ;
  • Dewi, Yesi Oktavia (Department of Pediatrics, Faculty of Medicine, Diponegoro University, Dr. Kariadi Hospital) ;
  • Pramono, Adriyan (Department of Nutrition, Center of Nutrition Research (CENURE), Faculty of Medicine, Diponegoro University) ;
  • Anam, Mohammad Syarofil (Department of Pediatrics, Faculty of Medicine, Diponegoro University, Dr. Kariadi Hospital)
  • 투고 : 2016.06.06
  • 심사 : 2016.11.26
  • 발행 : 2017.04.15

초록

Purpose: Tuberculosis (TB) remains a problem in the community. TB patients usually experience malnutrition, which is characterized by both decreased body weight (BW) and body fat percentage (BFP). Leptin, an important regulator of BW, also plays an important role in cellular immunity, which is integral to defense against Mycobacterium tuberculosis infection. We analyzed the effect of an anti-TB treatment regimen on the leptin level, BW, and BFP of children with TB. Methods: The design of this study was a group interrupted time series. The subjects were children with probable TB according to clinical criteria based on an Indonesian scoring system adopted from the Consensus of Expert Panel. BW; BFP; energy intake; fat and protein intake; and leptin levels before, 2 months after (intensive phase), and 6 months after (continuation phase) anti-TB treatment, were measured. About 40 children, aged 5-14 years, participated in this study. Results: The BW, BFP and leptin level increased from before treatment to after completion of the intensive phase and still showed an increased during the continuation phase: BW 18.65 kg, 19.75 kg, and 20.85 kg; BFP 18.3%, 19.5%, and 20.2%; and leptin level 1.9 mg/dL, 3.07 mg/dL, and 3.4 mg/dL, respectively (P<0.01). Conclusion: Leptin level, BW, and BFP increased throughout the course of anti-TB treatment, compared with pretreatment values. Further research is needed to compare the results with data for healthy children.

키워드

참고문헌

  1. Mustafa T. Does leptin have a role in immunity to tuberculosis? Indian J Med Res 2008;128:691-3.
  2. Nelson LJ, Wells CD. Global epidemiology of childhood tuberculosis. Int J Tuberc Lung Dis 2004;8:636-47.
  3. Herlina M, Nataprawira HM, Garna H. Association of serum C-reactive protein and leptin levels with wasting in childhood tuberculosis. Singapore Med J 2011;52:446-50.
  4. Zachariah R, Spielmann MP, Harries AD, Salaniponi FM. Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Trans R Soc Trop Med Hyg 2002; 96:291-4. https://doi.org/10.1016/S0035-9203(02)90103-3
  5. van Crevel R, Karyadi E, Netea MG, Verhoef H, Nelwan RH, West CE, et al. Decreased plasma leptin concentrations in tuberculosis patients are associated with wasting and inflammation. J Clin Endocrinol Metab 2002;87:758-63. https://doi.org/10.1210/jcem.87.2.8228
  6. van Lettow M, van der Meer JW, West CE, van Crevel R, Semba RD. Interleukin-6 and human immunodeficiency virus load, but not plasma leptin concentration, predict anorexia and wasting in adults with pulmonary tuberculosis in Malawi. J Clin Endocrinol Metab 2005;90:4771-6. https://doi.org/10.1210/jc.2004-2539
  7. Pavan Kumar N, Anuradha R, Andrade BB, Suresh N, Ganesh R, Shankar J, et al. Circulating biomarkers of pulmonary and extrapulmonary tuberculosis in children. Clin Vaccine Immunol 2013; 20:704-11. https://doi.org/10.1128/CVI.00038-13
  8. Zheng Y, Ma A, Wang Q, Han X, Cai J, Schouten EG, et al. Relation of leptin, ghrelin and inflammatory cytokines with body mass index in pulmonary tuberculosis patients with and without type 2 diabetes mellitus. PLoS One 2013;8:e80122. https://doi.org/10.1371/journal.pone.0080122
  9. Margetic S, Gazzola C, Pegg GG, Hill RA. Leptin: a review of its peripheral actions and interactions. Int J Obes Relat Metab Disord 2002;26:1407-33. https://doi.org/10.1038/sj.ijo.0802142
  10. Wieland CW, Florquin S, Chan ED, Leemans JC, Weijer S, Verbon A, et al. Pulmonary Mycobacterium tuberculosis infection in leptin-deficient ob/ob mice. Int Immunol 2005;17:1399-408. https://doi.org/10.1093/intimm/dxh317
  11. Schwenk A, Hodgson L, Rayner CF, Griffin GE, Macallan DC. Leptin and energy metabolism in pulmonary tuberculosis. Am J Clin Nutr 2003;77:392-8. https://doi.org/10.1093/ajcn/77.2.392
  12. Buyukoglan H, Gulmez I, Kelestimur F, Kart L, Oymak FS, Demir R, et al. Leptin levels in various manifestations of pulmonary tuberculosis. Mediators Inflamm 2007;2007:64859.
  13. Yang R, Barouch LA. Leptin signaling and obesity: cardiovascular consequences. Circ Res 2007;101:545-59. https://doi.org/10.1161/CIRCRESAHA.107.156596
  14. Park HK, Ahima RS. Physiology of leptin: energy homeostasis, neuroendocrine function and metabolism. Metabolism 2015;64: 24-34. https://doi.org/10.1016/j.metabol.2014.08.004
  15. Graham SM, Ahmed T, Amanullah F, Browning R, Cardenas V, Casenghi M, et al. Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel. J Infect Dis 2012;205 Suppl 2:S199-208. https://doi.org/10.1093/infdis/jis008
  16. Indonesian Ministry of Health. Petunjuk teknis manajemen TB anak (Technical guidelines for TB in children). Jakarta: Kemenkes RI, 2013:7-26.
  17. Malli F, Papaioannou AI, Gourgoulianis KI, Daniil Z. The role of leptin in the respiratory system: an overview. Respir Res 2010;11: 152. https://doi.org/10.1186/1465-9921-11-152
  18. Yamborisut U, Riabroy N, Phonrat B, Tungtrongchitr R. Serum leptin levels and body composition in obese Thai children. Southeast Asian J Trop Med Public Health 2009;40:544-52.
  19. Ubags ND, Stapleton RD, Vernooy JH, Burg E, Bement J, Hayes CM, et al. Hyperleptinemia is associated with impaired pulmonary host defense. JCI Insight 2016;1(8). pii: e82101.
  20. Tiliscan C, Arama V, Mihailescu R, Munteanu DI, Streinu-Cercel A, Ion DA, et al. Leptin expression in HIV-infected patients during antiretroviral therapy. Germs 2015;5:92-8. https://doi.org/10.11599/germs.2015.1076
  21. Mody A, Bartz S, Hornik CP, Kiyimba T, Bain J, Muehlbauer M, et al. Effects of HIV infection on the metabolic and hormonal status of children with severe acute malnutrition. PLoS One 2014;9:e102233. https://doi.org/10.1371/journal.pone.0102233
  22. Joshi JM. Tuberculosis chemotherapy in the 21 century: back to the basics. Lung India 2011;28:193-200. https://doi.org/10.4103/0970-2113.83977
  23. Benoit SC, Clegg DJ, Seeley RJ, Woods SC. Insulin and leptin as adiposity signals. Recent Prog Horm Res 2004;59:267-85. https://doi.org/10.1210/rp.59.1.267
  24. Paz-Filho G, Mastronardi CA, Licinio J. Leptin treatment: facts and expectations. Metabolism 2015;64:146-56. https://doi.org/10.1016/j.metabol.2014.07.014
  25. Mexitalia M, Yamauchi T, Utari A, Sjarif DR, Subagio HW, Soemantri A, et al. The role of uncoupling protein 2 and 3 genes polymorphism and energy expenditure in obese Indonesian children. J Pediatr Endocrinol Metab 2013;26:441-7.
  26. Steyn FJ, Xie TY, Huang L, Ngo ST, Veldhuis JD, Waters MJ, et al. Increased adiposity and insulin correlates with the progressive suppression of pulsatile GH secretion during weight gain. J Endocrinol 2013;218:233-44. https://doi.org/10.1530/JOE-13-0084
  27. Hill RJ, Davies PS. The validity of self-reported energy intake as determined using the doubly labelled water technique. Br J Nutr 2001;85:415-30. https://doi.org/10.1079/BJN2000281

피인용 문헌

  1. Altered Systemic Adipokine Levels in Pulmonary Tuberculosis and Changes following Treatment vol.99, pp.4, 2017, https://doi.org/10.4269/ajtmh.18-0206
  2. Changes in Host Response to Mycobacterium tuberculosis Infection Associated With Type 2 Diabetes: Beyond Hyperglycemia vol.9, pp.None, 2017, https://doi.org/10.3389/fcimb.2019.00342
  3. The Body Weights’ Follow Up Before and After 6 Months Therapy of Oral Anti-Tuberculosis Therapy in Children in Medan, Sumatra Utara vol.7, pp.20, 2019, https://doi.org/10.3889/oamjms.2019.448
  4. Endocrine and Metabolic Manifestations of Tuberculosis vol.16, pp.2, 2017, https://doi.org/10.17925/use.2020.16.2.88
  5. Using Changes in Weight-for-Age z Score to Predict Effectiveness of Childhood Tuberculosis Therapy vol.9, pp.2, 2017, https://doi.org/10.1093/jpids/piy138
  6. The Echo of Pulmonary Tuberculosis: Mechanisms of Clinical Symptoms and Other Disease-Induced Systemic Complications vol.33, pp.4, 2020, https://doi.org/10.1128/cmr.00036-20
  7. The Effects of High-Intensity Interval Training vs. Moderate-Intensity Continuous Training on Inflammatory Markers, Body Composition, and Physical Fitness in Overweight/Obese Survivors of Breast Cance vol.13, pp.17, 2017, https://doi.org/10.3390/cancers13174386