Abstract
BackgroundAdipokines have a wide range of effects and are linked to sepsis and septic shock. The aim of the present study was to describe the changes in adipokine levels in septic patients in relation to patients’ preseptic adipokine levels. Furthermore, we examined adipokines as prognostic markers.MethodsFourteen consecutive critically ill patients meeting the clinical criteria for severe sepsis or septic shock 3 days up to 1 month after major visceral surgery were enrolled prospectively. Plasma adipokines were measured preoperatively, 1 and 4 days after diagnosis of severe sepsis or septic shock following elective surgery.ResultsMedian plasma adiponectin levels were lowered and resistin and leptin levels elevated in sepsis compared with preseptic plasma levels. MCP-1, C-reactive protein and white blood cell count were higher in septic compared with preseptic patients.Survivors had significantly higher preseptic adipokine levels than non-survivors. Adiponectin levels of survivors decreased significant (on average by 33 %) at day one after onset of sepsis compared with preseptic levels. In contrast, median adiponectin levels of patients dying during sepsis showed a slight increase (11 %). Median BMI of survivors was 30 kg/m2, median BMI of non-survivors was 25, respectively.ConclusionsAdipokine levels change during the course of sepsis. Higher preseptic adiponectin levels and decreasing adiponectin levels after onset of sepsis are associated with survival of sepsis. Survival of overweight and obese patients was higher than in normal weight patients. Changes in adiponektin levels could be a prognostic marker for outcome of severe sepsis/septic shock following surgery.
Highlights
Adipokines have a wide range of effects and are linked to sepsis and septic shock
In this study, 14 consecutive critically ill patients meeting the clinical criteria for severe sepsis or septic shock defined by Bone [13] after major abdominal surgery procedures were prospectively enrolled between January 2011 and May 2014
The duration between surgery and the occurrence of subsequent severe sepsis/septic shock ranged from 3 days up to 1 month
Summary
Adipokines have a wide range of effects and are linked to sepsis and septic shock. The aim of the present study was to describe the changes in adipokine levels in septic patients in relation to patients’ preseptic adipokine levels. The complex dysregulated host response includes uncontrolled inflammation and immune suppression and is largely mediated by pro- and anti-inflammatory cytokines. White adipose tissue (WAT) is involved in the production of these pro- and antiinflammatory cytokines and the contribution of WAT to Hillenbrand et al Journal of Inflammation (2016) 13:30 co-morbidities that collectively define the metabolic syndrome [4]. In critically ill and septic patients, adipokines interact with inflammatory processes, and with coagulation. They have an impact on insulin resistance [5]. Some of the metabolic abnormalities in the metabolic syndrome share several common features with those of sepsis and multiple organ dysfunction syndrome of critical illness [6]
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