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    Plasma leptin levels increase to a greater extent following on-pump coronary artery surgery in type 2 diabetic patients than in nondiabetic patients
    (ELSEVIER IRELAND LTD, 2012) Guvener, Murat; Ucar, Halil Ibrahim; Oc, Mehmet; Pinar, Asli
    Aims: We aimed to evaluate whether leptin and ghrelin responses to cardiopulmonary bypass (CPB) are dependent on type 2 diabetes and whether these responses are associated with interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), cortisol and insulin. Methods: We examined stress-response patterns in plasma leptin, ghrelin, hsCRP, IL-6, cortisol and insulin levels before and up to 5 days after cardiopulmonary bypass in 20 patients with type 2 diabetes and 20 patients without diabetes. Results: Plasma leptin levels increased significantly in both groups (p < 0.05) and rose significantly higher in diabetics when compared with nondiabetic patients (p = 0.004). Plasma ghrelin levels increased significantly only in diabetics (p = 0.033). Patients with and without diabetes showed significantly elevated serum concentrations of IL-6, hsCRP, cortisol and insulin (p < 0.005 for IL-6, hsCRP; p < 0.05 for cortisol, insulin) but the difference between the two groups was nonsignificant. Leptin was independently predicted by hsCRP (p < 0.05, F = 2.9), gender (women p < 0.001, F = 4.7), body mass index (BMI p < 0.0001, F = 6.1) whereas ghrelin levels were not associated with any variables in the total patient population. (critical F = 2.26, p <= 0.05). Conclusions: Acute phase response in diabetics differs by higher leptin levels independent of BMI, gender and IL-6, hsCRP, insulin and cortisol levels. (C) 2012 Elsevier Ireland Ltd. All rights reserved.