Changes in Plasma Level of Endocrine Hormones in Lepromatous Leprosy Patients

Background

Leprosy affects various endocrine glands and causes disorders in internal organs in addition to the skin and peripheral nerves. These disorders are often silent and remain undiagnosed or underreported. Particularly, patterns of hormone changes during leprosy, particularly in lepromatous leprosy (LL) patients, is often associated with dysregulation of different endocrine and sex hormones. In this study, we aimed to assess changes in four endocrine hormones namely cortisol, dehydroepiandrosterone (DHEA), growth hormone (GH), and leptin among LL patients compared to apparently healthy controls.

Method

A total of 80 plasma samples were systematically retrieved based on quality, adequacy of sample volume, and appropriateness of linked clinical and socio-demographic data from a biorepository at the Armauer Hansen Research Institute (AHRI). Forty of the samples were obtained from LL patients (cases) and the remaining 40 from apparently healthy controls. Enzyme-linked immunosorbant assay (ELISA) was used to quantify levels of DHEA, cortisol, GH, and leptin hormones in the plasma samples. Data were analyzed using non-parametric statistics, Mann–Whitney U-test using GraphPad Prism Version 7.01 and a P-value < 0.05 was considered statistically significant.

Results

Plasma levels of cortisol concentration was significantly higher in LL cases (median = 111.4 ηg/ml, range = 20.54-525.7) compared to healthy controls (median = 51.98 ηg/ml, range = 3.805-328.4) (P = 0.003); whereas levels of GH and leptin were significantly lower in LL cases compared to healthy controls (median value for GH = 1.01 uIU/ml, range = 0.4625-86.82 and 2 uIU/ml, range = 0.5838-63.36, respectively (P = 0.022) and (median values for leptin = 891 ρg/ml, range= 728.4-21816 and 5147 ρg/ml, range = 730.4-52747, respectively (P < 0.0001). Although, it was not statistically significant, there was an apparent reduction in the plasma levels of DHEA among LL cases compared to healthy controls (P = 0.297).

Conclusion

Alteration of endocrine hormones seen in LL patients reflects clinical and immunological conditions during lepromatous leprosy; however, large-scale study is warranted to determine how leprosy causes such alteration in hormones and the interplay between endocrine hormones and the immune system during leprosy disease.