The circulating pattern of adiponectin and resistin in critically ill patients with sepsis
Dimitra Vassiliadi1, Marinella Tzanela1, Ioanna Dimopoulou2, Stylianos Orfanos2, Anastasia Kotanidou2, Apostolos Armaganidis2 & Stylianos Tsagarakis3
Several alterations of the metabolic processes develop during sepsis. Adiponectin and resistin are amongst the main adipokines that may contribute to the metabolic adaptations observed in the context of critical illness. However, there is scarce data on the circulating pattern of these adipokines in human sepsis. Therefore we aimed to describe the variation in circulating levels of resistin and adiponectin during the course of sepsis and examine whether they are related to the severity of sepsis or the outcome.
Patients and methods: Forty-four patients diagnosed with sepsis within the last 24-h. None of the patients received corticosteroids. Clinical severity was assessed using the ApacheII and SOFA scores. Adiponectin, resistin, IL-1, IL-6, IL-8, IL-10, IL-12 were measured in the morning on days 1, 4, 7, 10, and every 3 days thereafter until death or recovery.
Results: Severity of sepsis was a significant predictor of mortality (simple sepsis (S) compared to severe sepsis (SevS) and septic shock (SS): odds ratio for death: 0.088, P=0.027). 30 patients survived. Adiponectin levels increased over time (P=0.008); no significant difference between survivors and non-survivors was observed. Resistin levels did not change significantly over time. Although baseline resistin levels were not different between survivors and non-survivors, survivors had significantly lower resistin on recovery (17.2±2.2 vs 30.2±5.8 ng/ml, P<0.05). Baseline resistin correlated with ApacheII (r=0.45, P=0.006) and SOFA (r=0.53, r=0.0008) and was significantly lower in S compared to SevS and SS (14.8±10.8 vs 37.7±23.3 ng/ml, P<0.01). Resistin correlated with IL-6 and IL-10. No correlations between adiponectin and SOFA, ApacheII or cytokine levels were noted.
Conclusions: Although adiponectin levels rise during the course of sepsis no relationship with the severity of sepsis or the outcome was detected. Resistin levels were related to the severity of sepsis and the degree of inflammatory response. A prolonged elevation of resistin was associated with an unfavourable outcome.