Association of adiponectin levels and insulin demand in critically ill patients

Andreas Hillenbrand1, Manfred Weiss3,&nbsp;Uwe Knippschild1, Hans G Stromeyer1,&nbsp;Doris Henne-Bruns1, Markus Huber-Lang2,&dagger; Anna M Wolf1,&dagger;1Department of General, Visceral, and Transplantation Surgery, 2Department of Traumatology, Hand and Reconstructiv...

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Autores principales:	Andreas Hillenbrand, Manfred Weiss, Uwe Knippschild, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/dee10c59df414fcdb2505262f28a5dd0
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spelling	oai:doaj.org-article:dee10c59df414fcdb2505262f28a5dd02021-12-02T05:52:31ZAssociation of adiponectin levels and insulin demand in critically ill patients1178-7007https://doaj.org/article/dee10c59df414fcdb2505262f28a5dd02011-01-01T00:00:00Zhttp://www.dovepress.com/association-of-adiponectin-levels-and-insulin-demand-in-critically-ill-a6143https://doaj.org/toc/1178-7007Andreas Hillenbrand1, Manfred Weiss3,&nbsp;Uwe Knippschild1, Hans G Stromeyer1,&nbsp;Doris Henne-Bruns1, Markus Huber-Lang2,&dagger; Anna M Wolf1,&dagger;1Department of General, Visceral, and Transplantation Surgery, 2Department of Traumatology, Hand and Reconstructive Surgery, 3Department of Anesthesiology, University Hospital of Ulm, Ulm, Germany &dagger;These authors contributed equallyPurpose: Intensive care unit patients usually have a deregulated glucose homeostasis and present with hyperglycemia and hyperinsulinemia, suggesting overall insulin resistance. Adiponectin has significant anti-inflammatory and insulin-sensitizing effects and is diminished in morbidly obese and in critically ill patients. Reduced adiponectin could contribute to insulin resistance in these patients. We examined how far insulin demand in critically ill patients is correlated with patient adiponectin levels.Patients and methods: Adiponectin, resistin, leptin, insulin demand, minimal and maximal blood sugar levels, epinephrine, and hydrocortisone demand were measured 1 day after diagnosis of severe sepsis or septic shock in 25 patients (8 female, 17 male; median age 65 years; range: 31 to 87 years).Results: Insulin demand (range: 0&ndash;8 IU/h; median 3.5 IU) was positively correlated with serum adiponectin levels (median: 10.1 &micro;g/mL; range: 2.9&ndash;47.6 &micro;g/mL; r = +0.56, P &lt; 0.01). There was no significant correlation between insulin demand and leptin serum levels (median: 18.1 ng/mL; range: 0.3&ndash;80.7 ng/mL; r = +0.29, P = 0.08) or resistin serum levels (median: 103.9 ng/mL; range: 14.7&ndash;352.3 ng/mL; r = +0.13, P = 0.27). Epinephrine demand (median: 0.08 &micro;g/kgmin; range: 0.02&ndash;0.63 &micro;g/kgmin) was negatively correlated with male adiponectin levels (r = -0.58; P &lt; 0.01; females: r = -0.36; P = 0.19) and positively correlated with resistin levels (r = 0.43; P = 0.02). Patient body mass index (median 26 kg/m&sup2;; range: 18&ndash;37) was positively correlated with serum leptin (r = 0.60; P &lt; 0.01) but was not correlated with insulin demand (r = 0.19; P = 0.19), or adiponectin (females: r = -0.37, P = 0.18; males: r = -0.16, P = 0.27), or resistin levels (r = +0.17; P = 0.21).Conclusion: Adiponectin levels and insulin demand were positively correlated during sepsis. Adiponectin levels were negatively correlated with epinephrine demand in male patients and epinephrine demand was positively correlated with resistin levels, which might have increased insulin resistance. The relationship between adiponectin and insulin action in humans is more complex than often suggested.Keywords: adipokines, sepsis, diabetes, resistin, leptin Andreas HillenbrandManfred WeissUwe Knippschildet alDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2011, Iss default, Pp 45-51 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Andreas Hillenbrand Manfred Weiss Uwe Knippschild et al Association of adiponectin levels and insulin demand in critically ill patients
description	Andreas Hillenbrand1, Manfred Weiss3,&nbsp;Uwe Knippschild1, Hans G Stromeyer1,&nbsp;Doris Henne-Bruns1, Markus Huber-Lang2,&dagger; Anna M Wolf1,&dagger;1Department of General, Visceral, and Transplantation Surgery, 2Department of Traumatology, Hand and Reconstructive Surgery, 3Department of Anesthesiology, University Hospital of Ulm, Ulm, Germany &dagger;These authors contributed equallyPurpose: Intensive care unit patients usually have a deregulated glucose homeostasis and present with hyperglycemia and hyperinsulinemia, suggesting overall insulin resistance. Adiponectin has significant anti-inflammatory and insulin-sensitizing effects and is diminished in morbidly obese and in critically ill patients. Reduced adiponectin could contribute to insulin resistance in these patients. We examined how far insulin demand in critically ill patients is correlated with patient adiponectin levels.Patients and methods: Adiponectin, resistin, leptin, insulin demand, minimal and maximal blood sugar levels, epinephrine, and hydrocortisone demand were measured 1 day after diagnosis of severe sepsis or septic shock in 25 patients (8 female, 17 male; median age 65 years; range: 31 to 87 years).Results: Insulin demand (range: 0&ndash;8 IU/h; median 3.5 IU) was positively correlated with serum adiponectin levels (median: 10.1 &micro;g/mL; range: 2.9&ndash;47.6 &micro;g/mL; r = +0.56, P &lt; 0.01). There was no significant correlation between insulin demand and leptin serum levels (median: 18.1 ng/mL; range: 0.3&ndash;80.7 ng/mL; r = +0.29, P = 0.08) or resistin serum levels (median: 103.9 ng/mL; range: 14.7&ndash;352.3 ng/mL; r = +0.13, P = 0.27). Epinephrine demand (median: 0.08 &micro;g/kgmin; range: 0.02&ndash;0.63 &micro;g/kgmin) was negatively correlated with male adiponectin levels (r = -0.58; P &lt; 0.01; females: r = -0.36; P = 0.19) and positively correlated with resistin levels (r = 0.43; P = 0.02). Patient body mass index (median 26 kg/m&sup2;; range: 18&ndash;37) was positively correlated with serum leptin (r = 0.60; P &lt; 0.01) but was not correlated with insulin demand (r = 0.19; P = 0.19), or adiponectin (females: r = -0.37, P = 0.18; males: r = -0.16, P = 0.27), or resistin levels (r = +0.17; P = 0.21).Conclusion: Adiponectin levels and insulin demand were positively correlated during sepsis. Adiponectin levels were negatively correlated with epinephrine demand in male patients and epinephrine demand was positively correlated with resistin levels, which might have increased insulin resistance. The relationship between adiponectin and insulin action in humans is more complex than often suggested.Keywords: adipokines, sepsis, diabetes, resistin, leptin
format	article
author	Andreas Hillenbrand Manfred Weiss Uwe Knippschild et al
author_facet	Andreas Hillenbrand Manfred Weiss Uwe Knippschild et al
author_sort	Andreas Hillenbrand
title	Association of adiponectin levels and insulin demand in critically ill patients
title_short	Association of adiponectin levels and insulin demand in critically ill patients
title_full	Association of adiponectin levels and insulin demand in critically ill patients
title_fullStr	Association of adiponectin levels and insulin demand in critically ill patients
title_full_unstemmed	Association of adiponectin levels and insulin demand in critically ill patients
title_sort	association of adiponectin levels and insulin demand in critically ill patients
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/dee10c59df414fcdb2505262f28a5dd0
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Association of adiponectin levels and insulin demand in critically ill patients

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