Circulating adipokine levels and prognostic value in septic patients

Hillenbrand, Andreas; Xu, Pengfei; Zhou, Shaoxia; Blatz, Annette; Weiß, Manfred; Häfner, Sebastian; Henne‐Bruns, Doris; Knippschild, Uwe

doi:10.1186/s12950-016-0138-z

Cited by 30 publications

(35 citation statements)

References 24 publications

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“…In sepsis, higher adiponectin levels before sepsis and decreasing adiponectin levels after sepsis are associated with survival. Additionally, compared with patients who survived sepsis, O’Brien et al found lower adiponectin concentrations before sepsis in the subgroup of patients who died during the course of sepsis [ 33 ]. Finally, obesity may be treated more aggressively than other diseases, in part because it is associated with high risks of cardiovascular disease, insulin resistance, hypertension, and other comorbidities [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis

et al. 2017

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BackgroundThe role of increased body mass index (BMI) in sepsis is controversial. We aimed to evaluate the associations between overweight (25 kg/m2 < BMI ≤ 29.9 kg/m2), obese (30 kg/m2 < BMI ≤ 39.9 kg/m2) and morbidly obese (BMI > 40 kg/m2) BMIs and outcomes in septic patients.MethodsWe searched the PubMed, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov databases for studies published by December 1, 2016. Electronic database searches yielded 3713 articles, eight of which were included in this meta-analysis. Data were independently extracted by two reviewers, and a third reviewer participated in making decisions as needed. We used Review Manager to conduct the analysis, and the outcomes were reported with odds ratios (ORs) or mean differences (MDs). The primary outcome was mortality, and the secondary outcome was length of stay (LOS) in the intensive care unit (ICU) or the hospital.ResultsData from eight studies involving a total of 9696 patients were pooled in our final analysis. Compared with patients with normal BMI (18.5 kg/m2 < BMI ≤ 24.9 kg/m2), patients with BMI ≥ 25 kg/m2 exhibited decreased mortality (OR 0.81; 95% confidence interval (CI), 0.74–0.89, P < 0.0001). In subgroup analysis, compared with normal-weight patients, overweight patients had lower mortality (OR 0.87; 95% CI 0.77–0.97, P = 0.02), whereas obese (OR 0.89, 95% CI 0.72–1.10, P = 0.29) and morbidly obese (OR 0.64, 95% CI 0.38–1.08, P = 0.09) patients did not exhibit significantly reduced mortality.ConclusionsIn sepsis cases, overweight, but not obesity or morbid obesity, was associated with lower mortality. Further prospective studies are needed to clarify this relationship.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-017-0405-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis

et al. 2017

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“…However, there are conflicting results regarding these adipokines and the outcome from sepsis [ 11 – 21 ]. Although adipokines have been associated with the prognosis of sepsis, it is not clear if adipokines promotes an infectious process to become septic or are related to the outcome of the septic event [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Leptin independently predicts development of sepsis and its outcome

et al. 2017

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BackgroundSepsis is a life-threatening condition and obesity is related to the clinical outcome. The underlying reasons are incompletely understood, but the adipocyte derived hormones leptin and adiponectin may be involved.MethodsPatients aged 18 years or more with documented first time sepsis events were included in a nested case-referent study if they had participated in previous health surveys. Two matched referents free of known sepsis were identified. Circulating levels of leptin and adiponectin were determined in stored plasma, and their impact on a future sepsis event and its outcome was evaluated.ResultsWe identified 152 patients (62% women) with a sepsis event and a previous participation in a health survey. Eighty-three % had also blood samples from the acute event. Hyperleptinemia at health survey associated with a future sepsis event (OR 1.77, 95% CI 1.04–3.00) and with hospital death. After adjustment for BMI leptin remained associated with sepsis in men, but not in women. High levels in the acute phase associated with increased risk for in hospital death in women (OR 4.18, 95% CI 1.17–15.00), while being protective in men (OR 0.05, 95% CI 0.01–0.48). Furthermore, leptin increased more from baseline to the acute phase in men than in women. Adiponectin did not predict sepsis and did not relate to outcome.ConclusionsHyperleptinemia independently predicted the development of sepsis and an unfavourable outcome in men, and inertia in the acute response related to worse outcome.

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“…Increased and decreased adiponectin levels have been reported in septic patients when compared with healthy controls (24)(25)(26). Moreover, in a clinical study conducted by Hillenbrandet al, adiponectin levels measured 4 days after being diagnosed with sepsis were found to be lower than the values measured on day 1 (27). The reason for the higher adiponectin levels in sepsis patients in our study may be taking the average of adiponectin levels measured on 5 consecutive days.…”

Section: Discussionmentioning

confidence: 37%

İntrabdominal Sepsisli Hastalarda Serum Adıponektin Sevıyeleri İle Proinflamatuar Sitokin Düzeyleri, Apache-II Skorları ve Mortalite Arasındaki İlişki

Dikmen¹,

Yılmaz²,

Kerem³

et al. 2020

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Objectives: Adiponectin is an anti-inflammatory cytokine that is abundantly produced by adipocytes and have a wide range of effects in sepsis pathophysiology. This study was conducted to investigate whether there is a correlation between serum adiponectin, proinflammatory cytokines' levels, APACHE-II scores and mortality rates of the patients with sepsis, severe sepsis and septic shock. Patients and Methods: Forty-five patients who met the criteria for sepsis (n=18), severe sepsis (n=14) and septic shock (n=13) were included in this prospective study. Patients who underwent elective abdominal surgery without sepsis were identified as the control group. After the diagnosis of sepsis, blood samples were taken on the following 5 days for adiponectin, IL-6, IL-1β, TNF-α and procalcitonin levels. APACHE-II scores of the patients were calculated daily. All patients were followed for 28 days and mortalities were observed. Results: Ten of the patients died within 28 days. The serum adiponectin levels of the patients in the study group were statistically higher than those in the control group. Statistically, the adiponectin levels of the patients in the septic shock group were markedly lower than those of the patients in sepsis and severe sepsis groups. Serum adiponectin levels inversely correlated with blood levels of IL-6, IL-1β, TNF-α, procalcitonin, lactate and APACHE-II scores. Serum adiponectin levels were significantly higher in survivors. Conclusion: Adiponectin levels reveal differences between sepsis, severe sepsis and septic shock groups. In patients with septic shock, serum adiponectin levels were associated with mortality among patients. Serum adiponectin levels might be a negative predictive marker in patients with sepsis, severe sepsis and septic shock.

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Circulating adipokine levels and prognostic value in septic patients

Cited by 30 publications

References 24 publications

The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis

The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis

Leptin independently predicts development of sepsis and its outcome

İntrabdominal Sepsisli Hastalarda Serum Adıponektin Sevıyeleri İle Proinflamatuar Sitokin Düzeyleri, Apache-II Skorları ve Mortalite Arasındaki İlişki

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