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Changes in serum leptin concentration after corticosteroid treatment in preterm infants

The aim of this study was to investigate the effect of postnatal systemic dexamethasone on serum leptin, insulin and hormones of the hypothalamic‐pituitary‐adrenal (HPA) axis in preterm, very low birthweight (VLBW) infants. Nineteen VLBW infants who received a 3 wk dose tapering course of dexamethasone for treatment of bronchopulmonary dysplasia were prospectively enrolled. Blood for hormone assays was collected immediately before the start of the dexamethasone course (Td‐pre), 3 wk after commencement of the drug (Td‐end) and 2 wk after dexamethasone treatment had been stopped (Td‐post). In addition, 28 VLBW infants who participated in a concurrent longitudinal leptin study within the same period but did not receive corticosteroid had their serum leptin and insulin concentrations serially monitored. Blood specimens for the latter group of infants were obtained at 2 (Twk–2), 5 (Twk–5) and 7 (Twk–7) wk of postnatal age. Serum leptin and insulin at Td–end were significantly increased, whereas plasma ACTH and serum cortisol were significantly suppressed compared with the pretreatment (Td–pre) levels in the corticosteroid group (p > 0.0001 for leptin and insulin; p > 0.05 and p > 0.001 for ACTH and cortisol, respectively). In contrast, serum leptin and insulin at weeks 5 (Twk–5) and 7 (Twk–7) did not differ significantly from their respective levels at week 2 (Twk–2) in the non‐treatment group.