Relation of Leptin, Ghrelin and Inflammatory Cytokines with Body Mass Index in Pulmonary Tuberculosis Patients with and without Type 2 Diabetes Mellitus

Background: Pulmonary tuberculosis (TB) patients often suffer from anorexia and poor nutrition, causing weight loss. The peptide hormones leptin and its counterpart ghrelin, acting in the regulation of food intake and fat utilization, play an important role in nutritional balance. This study aimed to investigate the association of blood concentrations of leptin, ghrelin and inflammatory cytokines with body mass index (BMI) in TB patients with and without type 2 diabetes mellitus (T2DM). Methods: BMI, biochemical parameters and plasma levels of leptin, ghrelin and inflammatory cytokines were measured before the start of treatment in 27 incident TB patients with T2DM, 21 TB patients and 23 healthy subjects enrolled in this study. Results: The levels of leptin were significantly higher in TB patients (35.2 +/- 19.1 ng/ml) than TB+T2DM (12.6 +/- 6.1 ng/ml) and control (16.1 +/- 11.1 ng/ml) groups. The level of ghrelin was significantly lower in TB (119.9 +/- 46.1 pg/ml) and non-significantly lower in TB+T2DM (127.7 +/- 38.6 pg/ml) groups than control (191.6 +/- 86.5 pg/ml) group. The levels of TNF-alpha were higher, while IFN-gamma and IL-6 levels were lower in patients than in the control group. Leptin showed a negative correlation with BMI in TB (r=-0.622, p0.05) groups, but negative correlation with BMI in the control (r=-0.693, p