Serial changes in adiponectin and resistin in critically ill patients with sepsis: associations with sepsis phase, severity, and circulating cytokine levels.
OBJECTIVE
The aim of the present study was to describe the variation in adiponectin and resistin levels, 2 adipokines with opposing effects on metabolism, in mechanically ventilated patients with sepsis and their relationships to disease severity and cytokine levels.


METHODS
An observational prospective study was conducted in a secondary/tertiary unit. Forty-one mechanically ventilated patients diagnosed as having sepsis were included in the study. The Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores were estimated. Adiponectin, resistin, and cytokines were measured upon sepsis diagnosis and every 3 to 4 days thereafter until day 30. Adiponectin and resistin were also measured in 40 controls.


RESULTS
The patients had higher adiponectin (10.9 ± 6.1 μg/mL vs 6.0 ± 2.9 μg/mL, P < .001) and resistin (24.7 ng/mL vs 3.8 ng/mL, P < .001) levels compared with the controls. Adiponectin increased and resistin decreased significantly over time in the entire cohort. Resistin correlated with Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment, interleukin (IL)-6, IL-8, and IL-10 and was significantly higher in severe sepsis/septic shock compared with sepsis. No correlations between adiponectin and clinical scores were noted.


CONCLUSIONS
Adiponectin and resistin change reciprocally during the course of sepsis. Resistin relates to the severity of sepsis and the degree of inflammatory response. Adiponectin and resistin may play a critical role in the metabolic adaptations observed in sepsis.
First Department of Critical Care Medicine, Evangelismos Hospital and M. Simou Laboratory, Athens, Greece. dimitra.vas@gmail.com
Dimitra A
DA
Vassiliadi
Marinella
M
Tzanela
Anastasia
A
Kotanidou
Stylianos E
SE
Orfanos
Nikitas
N
Nikitas
Apostolos
A
Armaganidis
Michalis
M
Koutsilieris
Charis
C
Roussos
Stylianos
S
Tsagarakis
Ioanna
I
Dimopoulou
D018806:APACHE; D052242:Adiponectin / Q000096:biosynthesis*; D000328:Adult; D016638:Critical Illness; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016753:Interleukin-10 / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D016209:Interleukin-8 / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011446:Prospective Studies; D052243:Resistin / Q000096:biosynthesis*; D018805:Sepsis / Q000097:blood / Q000378:metabolism*; D013997:Time Factors
D052242:Adiponectin; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D052243:Resistin; D016753:Interleukin-10