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Critical Care

, 13:R105

First Online: 02 July 2009Received: 24 April 2009Revised: 08 June 2009Accepted: 02 July 2009


IntroductionAdiponectin plays an important role in the regulation of tissue inflammation and insulin sensitivity. Perturbations in adiponectin concentration have been associated with obesity and the metabolic syndrome. Data on adiponectin pathophysiology in critical illness are limited.

MethodsTwenty three critically ill patients 9 severe sepsis, 7 burns, 7 trauma. Adiponectin assays on Days 3 D3 and 7 D7. Simultaneous, cortisol, cortisone and CRP measurements. Data from 16 historical controls were used for comparison.

ResultsThe mean plasma adiponectin concentration for the ICU cohort on D3 and D7 were not significantly different 4.1 ± 1.8 and 5.0 ± 3.3 mcg-ml respectively, P = 0.38. However, these were significantly lower than the mean plasma adiponectin in the control population 8.78 ± 3.81 mcg-ml at D3 P < 0.0001 and D7 P = 0.002. Plasma adiponectin showed a strong correlation with plasma cortisol in the ICU group on both D3 R = 0.32, P < 0.01 and D7 R = 0.64, 0.001. There was an inverse correlation between plasma adiponectin and CRP on D7, R = -0.35.

ConclusionsIn this preliminary study, critical illness was associated with lower adiponectin concentrations as compared with controls. A significant relationship between plasma cortisol and adiponectin in critically ill patients was evident, both during the early and late phases. These data raise the possibility that adiponectin may play a part in the inflammatory response in patients with severe illness.

AbbreviationsAPACHEAcute Physiology and Chronic Health Evaluation

BMIbody mass index

CRPC-reactive protein

CVcoefficient of variation

D3day 3

D7day 7

SAPSsimplified acute physiology score

TNFtumour necrosis factor.

Electronic supplementary materialThe online version of this article doi:10.1186-cc7941 contains supplementary material, which is available to authorized users.

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Autor: Bala Venkatesh - Ingrid Hickman - Janelle Nisbet - Jeremy Cohen - John Prins


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