Journal
JOURNAL OF CRITICAL CARE
Volume 26, Issue 2, Pages 166-174Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2010.07.015
Keywords
Adiponectin; Sepsis; Mortality; Adipocytokine; Obesity; Diabetes
Categories
Funding
- German Research Foundation [DFG Ta434/2-1, SFB/TRR57, SFB 542 C14]
- Interdisciplinary Centre for Clinical Research within the faculty of Medicine at the RWTH Aachen University
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Purpose: Adiponectin has been proposed as an important regulator of glucose metabolism influencing obesity and insulin resistance, which are important risk factors for the outcome of critically ill patients. Moreover, experimental models of inflammation suggest protective anti-inflammatory properties of adiponectin. We therefore investigated the potential pathogenic role and prognostic value of circulating adiponectin levels in critical illness. Materials and methods: One hundred seventy critically ill patients (122 with sepsis and 48 without sepsis) were prospectively studied at admission to the medical intensive care unit (ICU) and compared with 60 healthy controls. Patients' survival was followed for approximately 3 years. Results: Adiponectin serum concentrations did not differ between healthy controls and critically ill patients, neither in patients with nor in patients without sepsis. However, patients with decompensated liver cirrhosis had significantly elevated serum adiponectin levels. Likewise to non-critically ill subjects, ICU patients with preexisting diabetes or obesity displayed significantly reduced circulating adiponectin. Inflammatory cytokines did not correlate with serum adiponectin. Interestingly, low adiponectin levels at ICU admission were an independent positive predictor of short-term and overall survival. Conclusions: Although serum concentrations did not differ in critically ill patients from controls, low adiponectin levels at admission to ICU have been identified as an independent predictor of survival. (C) 2011 Elsevier Inc. All rights reserved.
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