Total Parenteral Nutrition Increases Serum Leptin Concentration in Hospitalized, Undernourished Patients

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Abstract
Background: The hormone leptin has putative roles in both body weight homeostasis (chronic) and satiety (acute). To determine if this dual regulation is observed in hospitalized, undernourished patients, serum leptin concentration was measured before and during total parenteral nutrition (TPN) infusion. Methods: Six consecutive patients were considered undernourished, as assessed by an independent multidisciplinary nutrition team, and TPN was prescribed at an initial rate of between 5023.2 and 7333.2 kJ in the first 24 hours. Serum leptin, insulin, and glucose were measured before the infusion and at 3 and 22 hours after initiation of TPN. Results: Baseline serum leptin concentrations correlated well with the patient's body mass index (BMI; r2 = .85, p < .05). Three hours of TPN infusion produced only modest changes in circulating leptin. However, after 22 hours, leptin concentrations increased by 1.8 ± 0.5-fold (p < .05), and this increase was independent of any change in body weight. Conclusions: Basal leptin concentrations correlate well with BMI. TPN induces a rise in leptin concentration independent of body weight. Leptin secretion is dually regulated in hospitalized, undernourished patients. (Journal of Parenteral and Enteral Nutrition23:38-42, 1999)