title: Circulating anti-inflammatory adipokines High Molecular Weight Adiponectin and Zinc-α2-glycoprotein (ZAG) are inhibited in early sepsis, but increase with clinical recovery: a pilot study.
abstract: BACKGROUND
  Adipose tissue has been identified as an endocrine organ secreting adipokines involved in metabolic and inflammatory pathways. Adiponectin, an anti-inflammatory adipokine, is reduced in sepsis. High Molecular Weight (HMW) adiponectin, the biologically most relevant molecule, has been investigated very little in human sepsis. Zinc-alpha2-glycoprotein (ZAG) is a novel adipokine and its expression in adipose tissue is positively correlated with adiponectin expression. It is not yet known whether ZAG has a role in sepsis. In this study we assessed levels of HMW adiponectin and ZAG during different stages of sepsis.
  
  
  METHODS
  A prospective observational pilot study was carried out on 21 septic patients. Serum samples were taken on day 1 and 2 post ICU admission and on day of discharge. Samples were analysed for total and HMW adiponectin, HMW/total adiponectin ratio, and ZAG. Results were correlated with clinical and metabolic data.
  
  
  RESULTS
  There were no differences in total adiponectin, HMW adiponectin and ZAG plasma concentrations between day 1 (admission) and day 2 of the sepsis episode. Compared to admission, a significant increase in total and HMW adiponectin and ZAG was observed on the day of discharge when clinical improvement had been achieved. There was also an increase in the HMW/total adiponectin ratio at that time.
  
  
  CONCLUSIONS
  Our data demonstrate an increase in both HMW adiponectin and total adiponectin in patients who had clinically recovered from sepsis. The increase in HMW/total adiponectin ratio with improvement of the clinical condition suggests that HMW adiponectin may have a greater role in the inflammatory process and insulin resistance seen in sepsis. In this pilot study, we have also demonstrated a significant increase in ZAG in critically ill patients temporally related to recovery from sepsis.
authors.affiliation: Department of Obesity and Endocrinology, Institute of Ageing and Chronic Disease, University of Liverpool, Duncan Building, Daulby Street, L69 3GA Liverpool, UK ; Intensive Care Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Ingeborg D
authors.initials: ID
authors.lastname: Welters
authors.affiliation: Department of Obesity and Endocrinology, Institute of Ageing and Chronic Disease, University of Liverpool, Duncan Building, Daulby Street, L69 3GA Liverpool, UK.
authors.forename: Chen
authors.initials: C
authors.lastname: Bing
authors.affiliation: Department of Obesity and Endocrinology, Institute of Ageing and Chronic Disease, University of Liverpool, Duncan Building, Daulby Street, L69 3GA Liverpool, UK.
authors.forename: Cherlyn
authors.initials: C
authors.lastname: Ding
authors.affiliation: Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Leuwer
authors.affiliation: Department of Obesity and Endocrinology, Institute of Ageing and Chronic Disease, University of Liverpool, Duncan Building, Daulby Street, L69 3GA Liverpool, UK ; Intensive Care Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Hall
mesh_terms: D052242:Adiponectin / Q000378:metabolism*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D010865:Pilot Projects; D011446:Prospective Studies; D029589:Seminal Plasma Proteins / Q000378:metabolism*; D018805:Sepsis / Q000503:physiopathology*; D013997:Time Factors; D000090203:Zn-Alpha-2-Glycoprotein
chemical_list: D052242:Adiponectin; D029589:Seminal Plasma Proteins; D000090203:Zn-Alpha-2-Glycoprotein
keywords: Adipokines; Adiponectin; HMW adiponectin; Sepsis; Zinc-α2-glycoprotein