Serum adiponectin upon admission to the intensive care unit may predict mortality in critically ill patients.
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.
Koch
Alexander
A
Department of Medicine III, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
Sanson
Edouard
E
Voigt
Sebastian
S
Helm
Anita
A
Trautwein
Christian
C
Tacke
Frank
F
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
D052242:Adiponectin; D015415:Biomarkers; D016207:Cytokines