title: Serum adiponectin upon admission to the intensive care unit may predict mortality in critically ill patients.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Medicine III, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Koch
authors.forename: Edouard
authors.initials: E
authors.lastname: Sanson
authors.forename: Sebastian
authors.initials: S
authors.lastname: Voigt
authors.forename: Anita
authors.initials: A
authors.lastname: Helm
authors.forename: Christian
authors.initials: C
authors.lastname: Trautwein
authors.forename: Frank
authors.initials: F
authors.lastname: Tacke
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016638:Critical Illness / Q000401:mortality*; D016207:Cytokines / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000097:blood / Q000401:mortality; D055815:Young Adult
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D016207:Cytokines