Endocrine Abstracts (2013) 32 P972 | DOI: 10.1530/endoabs.32.P972

Differences in adipose tissue lipolysis in critically ill septic patients with and without shock

Dimitra Vassiliadi1, Ioannis Ilias2, Petros Kopterides3, Nikitas Nikitas3, Maria Theodorakopoulou3, Argyris Diamantakis3, George Dimitriadis1, Eleni Boutati1, Irini Maratou1 & Ioanna Dimopoulou3

12nd Department of Internal Medicine, Attikon Hospital, Athens, Greece; 2Department of Endocrinology E Venizelou Hospital, Athens, Greece; 32nd Department of Intensive Care, Attikon Hospital, Athens, Greece.

Introduction: Critical illness, and sepsis in particular, drives adipose tissue lipolysis up (with triglycerides (TG) being split to free fatty acids (FFA) and glycerol (GLYC)) to meet increased energy demands. Few studies have addressed lipolysis with tissue microdialysis (MD).

Aim: To assess indexes of lipolysis in septic patients with and without shock.

Subjects and methods: The study included 110 men and 73 women (mean age+S.D.: 62±17 years), 66 with SIRS/severe sepsis (SSe) and 117 with septic shock (SSho). All the subjects had a tissue MD catheter placed in femoral adipose tissue upon admission to the ICU. Plasma cholesterol, HDL, LDL, FFA, TG and MD GLYC were measured on days 1 and 6 in the ICU. Analysis was done with repeated measures ANOVA and Pearson’s correlation.

Results: Seventy-four patients died. Patients with SSho had lower LDL and higher MD GLYC levels compared to SIRS/SSe on days 1 and 6. Significant positive corellations were found between FFA and MD GLYC in patients with SSho on day 1 and in patients with SIRS/SSe on day 6.

Discussion: Lipolysis was apparently acutely more intense in patients with SSho on day 1 and subsequently subsided whereas it became more pronounced in patients with SIRS/SSe on day 6, verging on chronic critical illness. This dimorphism may provide clues for diversification of nutritional support (carbohydrates vs lipids) in critically ill patients; further studies are warranted.