Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

• Published in: Nutrients 2022-01, Vol.14 (1), p.226
• Main Authors: Paillaud, Elena, Poisson, Johanne, Granier, Clemence, Ginguay, Antonin, Plonquet, Anne, Conti, Catherine, Broussier, Amaury, Raynaud-Simon, Agathe, Bastuji-Garin, Sylvie
• Format: Article
• Language: English
• Subjects: Activities of daily living; Aged; Aged, 80 and over; Albumins; Biomarkers - analysis; C-reactive protein; Catheters; CD4 antigen; CD8 antigen; Confidence intervals; Cross Infection - etiology; Disease; Elder Nutritional Physiological Phenomena; Female; Geriatric Assessment; Geriatrics; Geriatry and gerontology; Health care; Health risks; hospital-acquired infection; Hospitalization; Human health and pathology; Humans; Immune status; Immunology; Infections; Inpatients - statistics & numerical data; Laboratories; Leptin; Leptin - blood; Life Sciences; Lymphocytes T; Male; Malnutrition; Medical research; Memory; Multivariate analysis; Nosocomial infections; Nutrition Assessment; Nutritional Status; Older people; older women; Patients; Prospective Studies; Rehabilitation; Risk Assessment; Statistical analysis
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14010226

We aimed to determine whether serum leptin levels are predictive of the occurrence of healthcare-associated infections (HAIs) in hospitalized older patients. In a prospective cohort, 232 patients had available data for leptin and were monitored for HAIs for 3 months. Admission data included comorbidities, invasive procedures, the Mini Nutritional Assessment (MNA), BMI, leptin, albumin and C-reactive protein levels, and CD4 and CD8 T-cell counts. Multivariate logistic regression modelling was used to identify predictors of HAIs. Of the 232 patients (median age: 84.8; females: 72.4%), 89 (38.4%) experienced HAIs. The leptin level was associated with the BMI ( < 0.0001) and MNA ( < 0.0001) categories. Women who experienced HAIs had significantly lower leptin levels than those who did not (5.9 μg/L (2.6-17.7) and 11.8 (4.6-26.3), respectively; = 0.01; odds ratio (OR) (95% confidence interval): 0.67 (0.49-0.90)); no such association was observed for men. In a multivariate analysis of the women, a lower leptin level was significantly associated with HAIs (OR = 0.70 (0.49-0.97)), independently of comorbidities, invasive medical procedures, and immune status. However, leptin was not significantly associated with HAIs after adjustments for malnutrition ( = 0.26) or albuminemia ( = 0.15)-suggesting that in older women, the association between serum leptin levels and subsequent HAIs is mediated by nutritional status.