Elevated CSF leptin in idiopathic intracranial hypertension: evidence for hypothalamic leptin resistance?

Objective: The aetiology of idiopathic intracranial hypertension (IIH) is not known, but its association with obesity is well recognised. Recent studies have linked obesity with abnormalities in circulating inflammatory and adiposity related cytokines. The aim of this study was to characterise adipokine and inflammatory cytokine profiles in IIH. Design: Paired serum and CSF specimens were collected from 26 patients with IIH and compared to 62 control subjects. Samples were analysed for leptin, resistin, adiponectin, insulin, IL-1beta, IL-6, IL-8 (CXCL8), TNFalpha, MCP-1 (CCL2), hepatocyte growth factor, nerve growth factor and PAI-1 using multiplex bead immunoassays. Results: CSF leptin was significantly higher in patients with IIH (p=0.001) compared to controls after correction for age, gender and body mass index (BMI). In the control population, BMI correlated with serum leptin (r = 0.34; p = 0.007) and CSF leptin (r = 0.51; p