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Comparative Study
. 2010 Sep 9:10:26.
doi: 10.1186/1471-2482-10-26.

Sepsis induced changes of adipokines and cytokines - septic patients compared to morbidly obese patients

Andreas Hillenbrand  1 , Uwe Knippschild, Manfred Weiss, Hubert Schrezenmeier, Doris Henne-Bruns, Markus Huber-Lang, Anna M Wolf
Affiliations
Comparative Study

Sepsis induced changes of adipokines and cytokines - septic patients compared to morbidly obese patients

Andreas Hillenbrand et al. BMC Surg. .

Abstract

Background: Hyperglycemia and insulin resistance frequently occur in critically ill and in morbidly obese (MO) patients. Both conditions are associated with altered serum levels of cytokines and adipokines. In addition, obesity related alterations in adipokine expression contribute to insulin resistance in metabolic syndrome. In this study we examined the serum adipocytokine profile in critically ill patients, MO patients, and healthy blood donors.

Methods: 33 patients who fulfilled the clinical criteria for severe sepsis or septic shock (SP) were prospectively enrolled in this study. A multiplex analysis was performed to evaluate plasma levels of adiponectin, resistin, leptin, active PAI-1, MCP-1, IL-1 alpha, IL-6, IL-8, IL-10, and TNF-alpha in 33 critically ill patients, 37 MO patients and 60 healthy blood donors (BD).

Results: In SP, adiponectin was significantly lowered and resistin, active PAI-1, MCP-1, IL-1 alpha, IL-6, IL-8, IL-10, and TNF-alpha were significantly elevated compared to BD. Leptin levels were unchanged. In MO, adiponectin and IL-8 were significantly lowered, leptin, active PAI-1, MCP-1, IL-1 alpha, IL-6, and IL-10 significantly elevated, whereas resistin was unaltered. In SP, adiponectin correlated negatively with BMI, SAPS II and SOFA scores, while resistin correlated positively with SAPS II and SOFA scores and leptin correlated positively with the BMI. Adiponectin was approximately equally diminished in SP and MO compared to BD. With the exception of active PAI-1, cytokine levels in SP were clearly higher compared to MO.

Conclusion: A comparable adipocytokine profile was determined in critically ill and MO patients. As in MO, SP showed reduced adiponectin levels and elevated MCP-1, active PAI-1, IL-1 alpha, IL-6, and IL-10 levels. Leptin is only elevated in MO, while resistin, IL-8, and TNF-alpha is only elevated in SP. As in MO patients, increased levels of proinflammatory cytokines and altered levels of adipokines may contribute to the development of insulin resistance in critically ill patients.

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Figures

Figure 1
Figure 1
Gender specific serum concentrations of adiponectin in septic (SP) and morbidly obese (MO) patients and healthy controls (BD). The top and bottom of the rectangle represent the 25th and 75th percentile. The line within the rectangle represents the median. The whiskers extend from the 5th percentile to the 95th percentile.
Figure 2
Figure 2
Gender specific serum concentrations of leptin in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 3
Figure 3
Serum concentrations of resistin in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 4
Figure 4
Serum concentrations of MCP-1 in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 5
Figure 5
Serum concentrations of active PAI-1 in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 6
Figure 6
Serum concentrations of TNF-α in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 7
Figure 7
Serum concentrations of IL-1a in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 8
Figure 8
Serum concentrations of IL-6 in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 9
Figure 9
Serum concentrations of IL-8 in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
Figure 10
Figure 10
Serum concentrations of IL-10 in septic (SP) and morbidly obese (MO) patients and healthy controls (BD).
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