title: Serum adipocyte fatty acid-binding protein levels in patients with critical illness are associated with insulin resistance and predict mortality.
abstract: BACKGROUND
  Hyperglycemia and insulin resistance are commonplace in critical illness, especially in patients with sepsis. Recently, several hormones secreted by adipose tissue have been determined to be involved in overall insulin sensitivity in metabolic syndrome-related conditions, including adipocyte fatty-acid binding protein (A-FABP). However, little is known about their roles in critical illness. On the other hand, there is evidence that several adipose tissue gene expressions change in critically ill patients.
  
  
  METHODS
  A total of 120 patients (72 with sepsis, 48 without sepsis) were studied prospectively on admission to a medical ICU and compared with 45 healthy volunteers as controls. Various laboratory parameters and metabolic and inflammatory profiles were assessed within 48 hours after admission. Clinical data were collected from medical records.
  
  
  RESULTS
  Compared with healthy controls, serum A-FABP concentrations were higher in all critically ill patients, and there was a trend of higher A-FABP in patients with sepsis. In multivariate correlation analysis in all critically ill patients, the serum A-FABP concentrations were independently related to serum creatinine, fasting plasma glucose, total cholesterol, TNF-alpha, albumin, and the Acute Physiology and Chronic Health Evaluation II scores. In survival analysis, higher A-FABP levels (> 40 ng/ml) were associated with an unfavorable overall survival outcome, especially in sepsis patients.
  
  
  CONCLUSIONS
  Critically ill patients have higher serum A-FABP concentrations. Moreover, A-FABP may potentially serve as a prognostic biomarker in critically ill patients with sepsis.
authors: Chi-Lun
authors: CL
authors: Huang
authors: Yen-Wen
authors: YW
authors: Wu
authors: Ai-Ru
authors: AR
authors: Hsieh
authors: Yu-Hsuan
authors: YH
authors: Hung
authors: Wen-Jone
authors: WJ
authors: Chen
authors: Wei-Shiung
authors: WS
authors: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness / Q000401:mortality*; D003430:Cross-Sectional Studies; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins
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