, Volume 47, Issue 2, pp 512–518 | Cite as

Sustained high levels of serum leptin rather than IL-6 observed in patients with postpartum thyroiditis during their first postpartum year

  • Huiling Guo
  • Xiu Liu
  • Chenyang Li
  • Yushu Li
  • Miao Sang
  • Zhongyan Shan
  • Weiping Teng
  • Haixia Guan
Original Article


The purpose of the study is to explore the roles of leptin and interleukin-6 (IL-6) during the first postpartum year in the occurrence and development of postpartum thyroiditis (PPT). We retrospectively collected serum samples from 57 PPT patients consisting of 34 overt PPT (O-PPT) and 23 subclinical PPT (S-PPT) in addition to 37 healthy postpartum women at four postpartum time points, i.e., 3-day and 3, 6, 12-month postpartum. Serum leptin and IL-6 levels were measured by radioimmunoassay and ELISA assay, respectively. Leptin level and leptin/BMI (LEP/BMI) ratio were higher in PPT patients than in control during the first postpartum year, but were not significantly different between O-PPT and S-PPT. However, a similar trend but did not reach significant difference in IL-6 level was observed during the postpartum period in PPT patients and control women. We conclude that a sustained high level of serum leptin after delivery may be involved in the pathogenesis of PPT. IL-6 does not contribute to the development of PPT.


Autoimmune Interleukin-6 Leptin Postpartum thyroiditis 



We are indebted to the postpartum women who participated in this study. We thank Renee Wang and LetPub Company for their linguistic assistance during the preparation of this manuscript. All the authors have nothing to declare. This study was supported by grants from the National Natural Science Foundation, Beijing, China (Grant #81170731).


  1. 1.
    N. Amino, H. Mori, Y. Iwatani, O. Tanizawa, M. Kawashima, I. Tsuge, K. Ibaragi, Y. Kumahara, K. Miyai, High prevalence of transient post-partum thyrotoxicosis and hypothyroidism. N. Engl. J. Med. 306, 849–852 (1982)PubMedCrossRefGoogle Scholar
  2. 2.
    A. Stagnaro-Green, Postpartum thyroiditis. Best Pract. Res. Clin. Endocrinol. Metab. 18, 303–316 (2004)PubMedCrossRefGoogle Scholar
  3. 3.
    A.F. Muller, H.A. Drexhage, A. Berghout, Postpartum thyroiditis and autoimmune thyroiditis in women of 1119 childbearing age: recent insights and consequences for antenatal and postnatal care. Endocr. Rev. 22, 605–630 (2001)PubMedCrossRefGoogle Scholar
  4. 4.
    H. Guan, C. Li, Y. Li, C. Fan, Y. Teng, Z. Shan, W. Teng, High iodine intake is a risk factor of post-partum thyroiditis: result of a survey from Shenyang, China. J. Endocrinol. Invest. 28, 876–881 (2005)PubMedCrossRefGoogle Scholar
  5. 5.
    J.L. Kuijpens, M. De Hann-Meulman, H.L. Vader, V.J. Pop, W.M. Wiersinga, H.A. Drexhage, Cell-mediated immunity and postpartum thyroid dysfunction: a possibility for the prediction of disease? J. Clin. Endocrinol. Metab. 83, 1959–1966 (1998)PubMedGoogle Scholar
  6. 6.
    A. Stagnaro-Green, S.H. Roman, R.H. Cobin, el-Harazy E, Wallenstein S, Davies TF: a prospective study of lymphocyte-initiated immunosuppression in normal pregnancy: evidence of a T-cell etiology for postpartum thyroid dysfunction. J. Clin. Endocrinol. Metab. 74, 645–653 (1992)PubMedGoogle Scholar
  7. 7.
    Y. Zhang, R. Proenca, M. Maffei, M. Barone, L. Leopold, J.M. Friedman, Positional cloning of the mouse obese gene and its human homologue. Nature 372, 425–432 (1994)PubMedCrossRefGoogle Scholar
  8. 8.
    F. Zhang, M.B. Basinski, J.M. Beals, S.L. Briggs, L.M. Churgay, D.K. Clawson, R.D. DiMarchi, T.C. Furman, J.E. Hale, H.M. Hsiung, B.E. Schoner, D.P. Smith, X.Y. Zhang, J.P. Wery, R.W. Schevitz, Crystal structure of the obese protein leptin-E 100. Nature 387, 206–209 (1997)PubMedCrossRefGoogle Scholar
  9. 9.
    C.S. Mantzoros, S.J. Moschos, Leptin: in search of role(s) in human physiology and pathophysiology. Clin. Endocrinol. (Oxf). 49, 551–567 (1998)PubMedCrossRefGoogle Scholar
  10. 10.
    G.M. Lord, G. Matarese, J.K. Howard, R.J. Baker, S.R. Bloom, R.I. Lechler, Leptin modulates the T-cell immune responses and reverses starvation-induced immunosuppression. Nature 394, 897–901 (1998)PubMedCrossRefGoogle Scholar
  11. 11.
    S. Barbosa Vde, J. Rêgo, N. Antônio da Silva, Possible role of adipokines in systemic lupus erythematosus and rheumatoid arthritis. Rev. Bras. Reumatol. 52, 271–287 (2012)Google Scholar
  12. 12.
    A.P. Weetman, R. Bright-Thomas, M. Freeman, Regulation of interleukin-6 release by human thyrocytes. J. Endocrinol. 127, 357–361 (1990)PubMedCrossRefGoogle Scholar
  13. 13.
    L. Bartalena, S. Brogioni, L. Grasso, E. Martino, Increased serum interleukin-6 concentration in patients with subacute thyroiditis: relationship with concomitant changes in serum T4-binding globulin concentration. J. Endocrinol. Invest. 16, 213–218 (1993)PubMedCrossRefGoogle Scholar
  14. 14.
    L. Bartalena, L. Grasso, S. Brogioni, F. Aghini-lombardi, L.E. Braverman, E. Martino, Serum interleukin-6 in amiodarone-induced thyrotoxicosis. J. Clin. Endocrinol. Metab. 78, 423–427 (1994)PubMedGoogle Scholar
  15. 15.
    M. Salvi, G. Girasole, M. Pedrazzoni, M. Passeri, N. Giuliani, R. Minelli, Increased serum concentrations of Interleukin-6 (IL-6) and soluble IL-6 receptor in patients with Graves’ disease. J. Clin. Endocrinol. Metab. 81, 2976–2979 (1996)PubMedGoogle Scholar
  16. 16.
    I. Celik, S. Akalin, T. Erbas, Serum levels of interleukin 6 and tumor necrosis factor-a in hyperthyroid patients before and after propylthiouracil treatment. Eur. J. Endocrinol. 132, 668–672 (1995)PubMedCrossRefGoogle Scholar
  17. 17.
    D. Teng, C. Li, Y. Teng, Y. Ouyang, Y. Li, W. Teng, Dynamic changes of IgG subtypes of thyroid peroxidase antibody in patients with postpartum thyroiditis. Gynecol. Obstet. Invest. 69, 24–29 (2010)PubMedCrossRefGoogle Scholar
  18. 18.
    X. Shi, C. Li, Y. Li, H. Guan, C. Fan, Y. Teng, Y. Ouyang, Z. Shan, W. Teng, Circulating lymphocyte subsets and regulatory T cells in patients with postpartum thyroiditis during the first postpartum year. Clin. Exp. Med. 9, 263–267 (2009)PubMedCrossRefGoogle Scholar
  19. 19.
    L. Siemińska, C. Wojciechowska, B. Kos-Kudła, B. Marek, D. Kajdaniuk, M. Nowak, J. Głogowska-Szelag, W. Foltyn, J. Strzelczyk, Serum concentrations of leptin, adiponectin, and interleukin-6 in postmenopausal women with Hashimoto’s thyroiditis. Endokrynol. Pol. 61, 112–116 (2010)PubMedGoogle Scholar
  20. 20.
    P.F. Teixeira, M.D. Cabral, N.A. Silva, D.V. Soares, V.B. Braulio, A.P. Couto, J.L. Henriques, A.J. Costa, A. Buescu, M. Vaisman, Serum leptin in overt and subclinical hypothyroidism: effect of levothyroxine treatment and relationship to menopausal status and body composition. Thyroid. 19, 443–450 (2009)PubMedCrossRefGoogle Scholar
  21. 21.
    R. Gunaydin, T. Kaya, A. Atay, N. Olmez, A. Hur, M. Koseoglu, Serum leptin levels in rheumatoid arthritis and relationship with disease activity. South. Med. J. 99, 1078–1083 (2006)PubMedCrossRefGoogle Scholar
  22. 22.
    D.A. Fraser, J. Thoen, J.E. Reseland, O. Forre, J. Kjeldsen-Kragh, Decreased CD4+ lymphocyte activation and increased interleukin-4 production in peripheral blood of rheumatoid arthritis patients after acute starvation. Clin. Rheumatol. 18, 394–401 (1999)PubMedCrossRefGoogle Scholar
  23. 23.
    G. Mazziotti, A.B. Parkes, M. Lage, L.D. Premawardhana, F.F. Casanueva, J.H. Lazarus, High leptin levels in women developing postpartum thyroiditis. Clin. Endocrinol. (Oxf). 60, 208–213 (2004)PubMedCrossRefGoogle Scholar
  24. 24.
    J.S. Flier, M. Harris, A.N. Hollenberg, Leptin, nutrition, and the thyroid: the why, the wherefore, and the wiring. J. Clin. Invest. 105, 859–861 (2000)PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    A. Oge, F. Bayraktar, F. Saygili, E. Guney, S. Demir, TSH influences serum leptin levels independent of thyroid hormones in hypothyroid and hyperthyroid patients. Endocr. J. 52, 213–217 (2005)PubMedCrossRefGoogle Scholar
  26. 26.
    M.J. Diekman, J.A. Romijn, E. Endert, H. Sauerwein, W.M. Wiersinga, Thyroid hormones modulate serum leptin levels: observations in thyrotoxic and hypothyroid women. Thyroid. 12, 1081–1086 (1998)CrossRefGoogle Scholar
  27. 27.
    U. Leonhardt, U. Ritzel, G. Schäfer, W. Becker, G. Ramadori, Serum leptin levels in hypo and hyperthyroidism. J. Endocrinol. 157, 75–79 (1998)PubMedCrossRefGoogle Scholar
  28. 28.
    S. Corbetta, P. Enafaro, S. Gianbona, L. Persani, W.F. Blum, P. Beck-Peccoz, Lack of effects of circulating thyroid hormone level on serum leptin concentrations. Eur. J. Endocrinol. 137, 659–663 (1997)PubMedCrossRefGoogle Scholar
  29. 29.
    M. Owecki, Z. El Ali, R. Wasko, E. Nikisch, A. Dziubandowska, A. Sulikowska, J. Sowiński, Circulating leptin levels are not influenced by thyroid status in hypothyroid and euthyroid women. Neuro Endocrinol. Lett. 28, 417–421 (2007)PubMedGoogle Scholar
  30. 30.
    J.H. Lazarus, A. Kokandi, Thyroid disease in relation to pregnancy: a decade of change. Clin. Endocrinol. (Oxf). 53, 265–278 (2000)PubMedCrossRefGoogle Scholar
  31. 31.
    A. Kokandi, A. Parkes, L. Premawardhana, R. John, J. Lazarus, Association of postpartum thyroid dysfunction with antepartum hormonal and immunological changes. J. Clin. Endocrinol. Metab. 88, 1126–1132 (2003)PubMedCrossRefGoogle Scholar
  32. 32.
    G. Matarese, A. La Cava, V. Sanna, G.M. Lord, R.I. Lechler, S. Fontana, S. Zappacosta, Balancing susceptibility to infection and autoimmunity: a role for leptin? Trends Immunol. 23, 182–187 (2002)PubMedCrossRefGoogle Scholar
  33. 33.
    G. Matarese, V. Sanna, A. Di Giacomo, G.M. Lord, J.K. Howard, S.R. Bloom, R.I. Lechler, S. Fontana, S. Zappacosta, Leptin potentiates experimental autoimmune encephalomyelitis in SJL female mice and confers susceptibility to males. Eur. J. Immunol. 31, 1324–1332 (2001)PubMedCrossRefGoogle Scholar
  34. 34.
    V. Sanna, A. Di Giacomo, A. La Cava, R.I. Lechler, S. Fontana, S. Zappacosta, G. Matarese, Leptin surge precedes onset of autoimmune encephalomyelitis and correlates with development of pathogenic T cell responses. J. Clin. Invest. 111, 241–250 (2003)PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    L. Ahmad, A. Parkes, J. Lazarus, L. Bartalena, E. Martino, E. Diamond, A. Stagnaro-Green, Interleukin-6 levels are not increased in women with postpartum thyroid dysfunction. Thyroid. 8, 371–375 (1998)PubMedCrossRefGoogle Scholar
  36. 36.
    A.B. Pedro, J.H. Romaldini, K. Takei, Changes of serum cytokines in hyperthyroid Graves’ disease patients at diagnosis and during methimazole treatment. Neuroimmunomodulation 18, 45–51 (2011)PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Huiling Guo
    • 1
  • Xiu Liu
    • 1
  • Chenyang Li
    • 2
  • Yushu Li
    • 1
  • Miao Sang
    • 1
  • Zhongyan Shan
    • 1
  • Weiping Teng
    • 1
  • Haixia Guan
    • 1
  1. 1.Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University; Institute of Endocrinology, The Liaoning Provincial Key Laboratory of Endocrine Diseases, China Medical UniversityShenyangPeople’s Republic of China
  2. 2.Department of Gynecology and ObstetricsShenyang Women’s and Children’s HospitalShenyangPeople’s Republic of China

Personalised recommendations