Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 4/2009

Open Access 01-08-2009 | Research

Adiponectin, retinol-binding protein 4, and leptin in protracted critical illness of pulmonary origin

Authors: Lies Langouche, Sarah Vander Perre, Jan Frystyk, Allan Flyvbjerg, Troels Krarup Hansen, Greet Van den Berghe

Published in: Critical Care | Issue 4/2009

Login to get access

Abstract

Introduction

Critically ill patients requiring intensive care uniformly develop insulin resistance. This is most pronounced in patients with sepsis. Recently, several hormones secreted by adipose tissue have been identified to be involved in overall insulin sensitivity in metabolic syndrome-related conditions. However, little is known about these adipokines in critical illness.

Methods

We studied circulating levels of the adipokines adiponectin, retinol-binding protein 4 (RBP4), and leptin during critical illness, and the impact of intensive insulin therapy, a therapy shown to affect insulin sensitivity, in serum samples from prolonged critically ill patients with a respiratory critical illness (n = 318). For comparison, we studied healthy subjects (n = 22) and acutely stressed patients (n = 22).

Results

During acute critical illness, circulating levels of adiponectin, RBP4, and leptin were low. Patients with sepsis had lower levels of leptin and RBP4 than did nonseptic patients. When critical illness was sustained, adipokine levels returned to normal reference values. Insulin therapy enhanced adiponectin, blunted the rise of RBP4, and did not alter leptin levels.

Conclusions

Acute critical illness is associated with immediate, but transiently low serum adipokine levels. Adiponectin and RBP4 are associated with altered insulin resistance in critical illness.
Appendix
Available only for authorised users
Literature
1.
Van Cromphaut SJ, Vanhorebeek I, Berghe G: Glucose metabolism and insulin resistance in sepsis. Curr Pharm Des 2008, 14: 1887-1899. 10.2174/138161208784980563CrossRefPubMed
2.
Okamoto Y, Kihara S, Funahashi T, Matsuzawa Y, Libby P: Adiponectin: a key adipocytokine in metabolic syndrome. Clin Sci (Lond) 2006, 110: 267-278.CrossRef
3.
Wang C, Mao X, Wang L, Liu M, Wetzel MD, Guan KL, Dong LQ, Liu F: Adiponectin sensitizes insulin signaling by reducing p70 S6 kinase-mediated serine phosphorylation of IRS-1. J Biol Chem 2007, 282: 7991-7996. 10.1074/jbc.M700098200CrossRefPubMed
4.
Graham TE, Yang Q, Bluher M, Hammarstedt A, Ciaraldi TP, Henry RR, Wason CJ, Oberbach A, Jansson PA, Smith U, Kahn BB: Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med 2006, 354: 2552-2563. 10.1056/NEJMoa054862CrossRefPubMed
5.
Yang Q, Graham TE, Mody N, Preitner F, Peroni OD, Zabolotny JM, Kotani K, Quadro L, Kahn BB: Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature 2005, 436: 356-362. 10.1038/nature03711CrossRefPubMed
6.
Kolaczynski JW, Nyce MR, Considine RV, Boden G, Nolan JJ, Henry R, Mudaliar SR, Olefsky J, Caro JF: Acute and chronic effects of insulin on leptin production in humans: studies in vivo and in vitro. Diabetes 1996, 45: 699-701. 10.2337/diabetes.45.5.699CrossRefPubMed
7.
Langouche L, Perre S, Wouters PJ, D'Hoore A, Hansen TK, Berghe G: Effect of intensive insulin therapy on insulin sensitivity in the critically ill. J Clin Endocrinol Metab 2007, 92: 3890-3897. 10.1210/jc.2007-0813CrossRefPubMed
8.
Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, Van Wijngaerden E, Bobbaers H, Bouillon R: Intensive insulin therapy in the medical ICU. N Engl J Med 2006, 354: 449-461. 10.1056/NEJMoa052521CrossRefPubMed
9.
Moody BJ: Changes in the serum concentrations of thyroxine-binding prealbumin and retinol-binding protein following burn injury. Clin Chim Acta 1982, 118: 87-92. 10.1016/0009-8981(82)90229-7CrossRefPubMed
10.
Jeevanandam M, Begay CK, Petersen SR: Plasma leptin levels in trauma patients: effect of adjuvant recombinant human growth hormone in intravenously fed multiple trauma patients. JPEN J Parenter Enteral Nutr 1998, 22: 340-346. 10.1177/0148607198022006340CrossRefPubMed
11.
Tsuchihashi H, Yamamoto H, Maeda K, Ugi S, Mori T, Shimizu T, Endo Y, Hanasawa K, Tani T: Circulating concentrations of adiponectin, an endogenous lipopolysaccharide neutralizing protein: decrease in rats with polymicrobial sepsis. J Surg Res 2006, 134: 348-353. 10.1016/j.jss.2006.01.001CrossRefPubMed
12.
Boden G, Chen X, Mozzoli M, Ryan I: Effect of fasting on serum leptin in normal human subjects. J Clin Endocrinol Metab 1996, 81: 3419-3423. 10.1210/jc.81.9.3419PubMed
13.
Vitkova M, Klimcakova E, Kovacikova M, Valle C, Moro C, Polak J, Hanacek J, Capel F, Viguerie N, Richterova B, Bajzova M, Hejnova J, Stich V, Langin D: Plasma levels and adipose tissue messenger ribonucleic acid expression of retinol-binding protein 4 are reduced during calorie restriction in obese subjects but are not related to diet-induced changes in insulin sensitivity. J Clin Endocrinol Metab 2007, 92: 2330-2335. 10.1210/jc.2006-2668CrossRefPubMed
14.
Yang WS, Lee WJ, Funahashi T, Tanaka S, Matsuzawa Y, Chao CL, Chen CL, Tai TY, Chuang LM: Weight reduction increases plasma levels of an adipose-derived anti-inflammatory protein, adiponectin. J Clin Endocrinol Metab 2001, 86: 3815-3819. 10.1210/jc.86.8.3815CrossRefPubMed
15.
Wajchenberg BL: Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 2000, 21: 697-738. 10.1210/er.21.6.697CrossRefPubMed
16.
Schulze MB, Rimm EB, Shai I, Rifai N, Hu FB: Relationship between adiponectin and glycemic control, blood lipids, and inflammatory markers in men with type 2 diabetes. Diabetes Care 2004, 27: 1680-1687. 10.2337/diacare.27.7.1680CrossRefPubMed
17.
Mantzoros CS, Li T, Manson JE, Meigs JB, Hu FB: Circulating adiponectin levels are associated with better glycemic control, more favorable lipid profile, and reduced inflammation in women with type 2 diabetes. J Clin Endocrinol Metab 2005, 90: 4542-4548. 10.1210/jc.2005-0372CrossRefPubMed
18.
Wu X, Thomas SJ, Herndon DN, Sanford AP, Wolf SE: Insulin decreases hepatic acute phase protein levels in severely burned children. Surgery 2004, 135: 196-202. 10.1016/j.surg.2003.08.018CrossRefPubMed
19.
Janke J, Engeli S, Boschmann M, Adams F, Bohnke J, Luft FC, Sharma AM, Jordan J: Retinol-binding protein 4 in human obesity. Diabetes 2006, 55: 2805-2810. 10.2337/db06-0616CrossRefPubMed
20.
Promintzer M, Krebs M, Todoric J, Luger A, Bischof MG, Nowotny P, Wagner O, Esterbauer H, Anderwald C: Insulin resistance is unrelated to circulating retinol binding protein and protein C inhibitor. J Clin Endocrinol Metab 2007, 92: 4306-4312. 10.1210/jc.2006-2522CrossRefPubMed
21.
Bernard AM, Vyskocil AA, Mahieu P, Lauwerys RR: Assessment of urinary retinol-binding protein as an index of proximal tubular injury. Clin Chem 1987, 33: 775-779.PubMed
22.
Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R: Intensive insulin therapy in critically ill patients. N Engl J Med 2001, 345: 1359-1367. 10.1056/NEJMoa011300CrossRefPubMed
23.
Carlson GL, Saeed M, Little RA, Irving MH: Serum leptin concentrations and their relation to metabolic abnormalities in human sepsis. Am J Physiol 1999, 276: E658-E662.PubMed
24.
Langouche L, Meersseman W, Perre S, Milants I, Wouters PJ, Hermans G, Gjedsted J, Hansen TK, Arnout J, Wilmer A, Schetz M, Berghe G: Effect of insulin therapy on coagulation and fibrinolysis in medical intensive care patients. Crit Care Med 2008, 36: 1475-1480. 10.1097/CCM.0b013e31816f7baeCrossRefPubMed
25.
Chen K, Li F, Li J, Cai H, Strom S, Bisello A, Kelley DE, Friedman-Einat M, Skibinski GA, McCrory MA, Szalai AJ, Zhao AZ: Induction of leptin resistance through direct interaction of C-reactive protein with leptin. Nat Med 2006, 12: 425-432. 10.1038/nm1372CrossRefPubMed
26.
Bornstein SR, Preas HL, Chrousos GP, Suffredini AF: Circulating leptin levels during acute experimental endotoxemia and antiinflammatory therapy in humans. J Infect Dis 1998, 178: 887-890. 10.1086/515349CrossRefPubMed
27.
Tzanela M, Orfanos SE, Tsirantonaki M, Kotanidou A, Sotiropoulou C, Christophoraki M, Vassiliadi D, Thalassinos NC, Roussos C: Leptin alterations in the course of sepsis in humans. In Vivo 2006, 20: 565-570.PubMed
28.
Arnalich F, Lopez J, Codoceo R, Jim M, Madero R, Montiel C: Relationship of plasma leptin to plasma cytokines and human survival in sepsis and septic shock. J Infect Dis 1999, 180: 908-911. 10.1086/314963CrossRefPubMed
29.
Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis: the ACCP/SCCM Consensus Conference Committee: American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992, 101: 1644-1655. 10.1378/chest.101.6.1644CrossRefPubMed
Metadata
Title
Adiponectin, retinol-binding protein 4, and leptin in protracted critical illness of pulmonary origin
Authors
Lies Langouche
Sarah Vander Perre
Jan Frystyk
Allan Flyvbjerg
Troels Krarup Hansen
Greet Van den Berghe
Publication date
01-08-2009
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2009
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7956

Other articles of this Issue 4/2009

Critical Care 4/2009 Go to the issue

Commentary

Recently published papers: A review of novel strategies in the prevention of hospital-acquired infections, the ability of intensivists to perform echocardiography, and the benefit of polymyxin B haemoperfusion in abdominal sepsis

Research

Comparison of two non-bronchoscopic methods for evaluating inflammation in patients with acute hypoxaemic respiratory failure

Research

Critical illness-related corticosteroid insufficiency in patients with severe acute biliary pancreatitis: a prospective cohort study

Viewpoint

Cognitive dysfunction after critical illness: measurement, rehabilitation, and disclosure

Research

Determinants of mortality in non-neutropenic ICU patients with candidaemia

Commentary

Vasopressin and ischaemic heart disease: more than coronary vasoconstriction?