Association of serum C-reactive protein and leptin levels with wasting in childhood tuberculosis

Herlina M, Nataprawira HMD, Garna H
Correspondence: Dr Murfariza Herlina, murfariza_h@yahoo.co.id

ABSTRACT
Introduction Wasting is a systemic manifestation of tuberculosis (TB) and is often thought to affect the severity and outcome of the disease. Leptin and several cytokines/proteins are thought to play a role in the relationship between TB, nutritional status and host immune response. The aim of this study was to determine the association of C-reactive protein (CRP), an inflammatory response protein and serum leptin levels with wasting in childhood TB.
Methods A cross-sectional observational analytic study was conducted at two hospitals in West Java from January to March 2010. The subjects were 13 children aged 2–120 months who were infected with TB and 26 healthy children of the same age and gender as the comparison group. History-taking and anthropometric, physical, serum CRP and leptin examinations were conducted for each subject. The association of CRP and serum leptin levels with wasting in childhood TB was studied.
Results Serum leptin levels were lower (95 percent confidence interval [CI] 314.0–1,228.9 pg/mL, p-value less than 0.001) and serum CRP levels were higher (95 percent CI 16.5–81.1 mg/L) in the subjects than in the comparison group. There were positive correlations between leptin and body mass index (p-value less than 0.001) and between CRP and wasting (p-value less than 0.001), but a negative correlation between leptin and wasting (p-value less than 0.001).
Conclusion Elevated serum CRP levels and a decrease in serum leptin levels are associated with an increase in wasting in childhood TB.

Keywords: childhood tuberculosis, C-reactive protein, leptin, wasting
Singapore Med J 2011; 52(6): 446-450