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

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.