title: Assessment of adipose tissue metabolism by means of subcutaneous microdialysis in patients with sepsis or circulatory failure.
abstract: To evaluate the role of adipose tissue in the metabolic stress response of critically ill patients, the release of glycerol and lactate by subcutaneous adipose tissue was assessed by means of microdialysis in patients with sepsis or circulatory failure and in healthy subjects. Patients with sepsis had lower plasma free fatty acid concentrations and non-significant elevations of plasma glycerol concentrations, but higher adipose-systemic glycerol concentrations gradients than healthy subjects or patients with circulatory failure, indicating a stimulation of subcutaneous adipose lipolysis. They also had a higher lipid oxidation. Lipid metabolism (adipose-systemic glycerol gradients, lipid oxidation) was not altered in patients with circulatory failure. These observations highlight major differences in lipolysis and lipid utilization between patients with sepsis and circulatory failure. Hyperlactataemia was present in both groups of patients, but the adipose-systemic lactate concentration gradient was not increased, indicating that lactate production by adipose tissue was not involved. This speaks against a role of adipose tissue in the development of hyperlactataemia in critically ill patients.
authors.affiliation: Surgical Intensive Care Unit, University Hospital, Lausanne, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Martinez
authors.forename: Rene
authors.initials: R
authors.lastname: Chiolero
authors.forename: Marc
authors.initials: M
authors.lastname: Bollman
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Revelly
authors.forename: Mette
authors.initials: M
authors.lastname: Berger
authors.forename: Christine
authors.initials: C
authors.lastname: Cayeux
authors.forename: Luc
authors.initials: L
authors.lastname: Tappy
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005947:Glucose / Q000378:metabolism; D005990:Glycerol / Q000378:metabolism; D006801:Humans; D007239:Infections / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D019344:Lactic Acid / Q000097:blood / Q000378:metabolism; D050356:Lipid Metabolism; D008297:Male; D017551:Microdialysis; D008875:Middle Aged; D009994:Osmolar Concentration; D010084:Oxidation-Reduction; D012769:Shock / Q000097:blood / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D019344:Lactic Acid; D005947:Glucose; D005990:Glycerol