Association of adiponectin levels and insulin demand in critically ill patients

Figures & data

Table 1 Gender, age, underlying reason of sepsis, side diagnosis, C-reactive protein levels, white blood count, self-reported (or estimated) body mass index, and Simplified Acute Physiology Score (SAPS II) without Glasgow Coma Scale of the 25 septic patients

Age/gender	Underlying cause of sepsis	CRP (mg/L)	White bloodcount (G/l)	BMI	Side diagnosis	SAPS II (without GCS)	SOFA (without GCS)	Sepsis scorea
62/m	Acute necrotizing pancreatitis	85	12.7	27	Spastic hemi paresis, nicotine and AA/D	49	10	6
83/m	Perforated gastric ulcer	334	44.8	25	NIDDM, aHT, TAA	50	10	6
67/m	Postoperative pancreatic fistula	259	46.2	29	NIDDM, aHT	21	7	6
42/f	Necrotizing fasciitis	323	17.5	28	–	58	9	7
65/m	Necrotizing fasciitis	283	24.3	25	DIDDM, aHT, TAA, RI	29	11	6
66/m	Ischemic colitis	289	18.2	26	DIDDM, aHT; RI; PAOD	34	9	6
63/m	Postoperative bile peritonitis	266	12.9	37	CHD, adipositas, NIDDM, aHT	31	9	6
64/m	Postoperative paralytic ileus	250	16.2	30	–	24	10	6
86/f	Perforated duodenal ulcers	273	37.7	31	aHT, dementia	31	5	4
50/m	Esophageal perforation	138	15.5	26	Nicotine and AA/D; liver cirrhosis	40	11	6
69/m	Acute necrotizing pancreatitis	219	14.7	23	Nicotine and AA/D	24	8	6
44/m	Blunt chest trauma	135	9.7	32	–	29	9	6
67/m	Colon anastomosis insufficiency	319	28,9	21	Ulcerative colitis	47	11	6
65/m	Arterial bypass infection	259	17.5	26	PAOD, AA/D, COPD, HF	37	9	6
58/f	Gastric ulcers peroration	259	16.9	32	Nicotine and AA/D, liver cirrhosis, aHT, asthma	53	10	6
31/m	Pleural empyema	330	17.5	28	–	29	7	6
64/m	Colon anastomosis insufficiency	102	21.6	23	–	46	11	6
66/m	Gastric ulcers peroration	200	26.7	24	CHD, PAOD, COPD	48	9	4
87/f	Gastric ulcers peroration	213	16.3	22	aHT, TAA, HF	41	5	4
80/f	Anaphylactic shock	134	14.3	25	NIDDM, aHT	54	5	5
81/f	Postoperative abdominal infection	274	37.3	24	COPD	46	6	6
87/f	Aspiration pneumonia	235	18.9	28	COPD	54	9	6
50/f	Retroperitoneal abscess	178	18.8	26	RI, aHT	31	3	4
44/m	Necrotizing fasciitis	130	15.1	31	Nicotine and AA/D, RI	28	6	6
80/m	Empyema	225	17.6	18	COPD, nicotine abuse, RI	31	9	4

Note:

a Sepsis score (Bone et al¹⁰): 4, sepsis, 5, severe sepsis, 6, septic shock.

Abbreviations: AA/D, alcohol abuse/dependence; aHT, arterial hypertension; CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; GCS, Glasgow Coma Scale; G/I, Giga/liter; HF, heart failure; NIDDM, noninsulin dependent diabetes mellitus; PAOD, peripheral artery occlusive disease; RI, renal insufficiency; TAA, tachyarrhythmia absoluta.

Figure 1 A,B) Insulin demand after diagnosis of sepsis and serum adiponectin levels of female (Figure 1A) and male (Figure 1B) patients. The 2 extreme values of adiponectin (47.6 μg/mL in female patients and 32.6 μg/mL in male patients) represent the 2 patients with the lowest body mass index (22 kg/m² and 18 kg/m²) and the lowest leptin levels (0.9 ng/mL and 0.3 ng/mL, respectively), although body mass index showed no significant negative correlation with adiponectin levels (females: r = −0.37, P = 0.18; males: r = −0.16, P = 0.27).

Table 2 Correlation of adipokines with insulin and epinephrine application in patients with sepsis (correlation coefficient r and P values)

Correlation of	With	All patients	Female	Male
Insulin	Adiponectin	0.57; <0.01	0.61; 0.05	0.53; 0.01
Insulin	Leptin	0.29; 0.08	−0.24; 0.28	0.53; 0.014
Insulin	Resistin	0.13; 0.27	−0.02; 0.48	0.24; 0.18
Insulin	Hydrocortisone	0.52; P < 0.01	0.36; 0.19	0.59; <0.01
Insulin	BMI	0.19; 0.19	0.12; 0.39	0.22; 0.20
Epinephrine	Adiponectin	−0.54; <0.01	−0.36; 0.19	−0.58; <0.01
Epinephrine	Resistin	0.43; 0.02	0.79; 0.01	0.23; 0.19
BMI	Adiponectin	−0.17; 0.21	−0.37; 0.18	−0.16; 0.27
BMI	Leptin	0.60; <0.01	0.61; 0.05	0.59; <0.01
BMI	Resistin	0.17; 0.21	0.68; 0.03	−0.02; 0.47

Note: Bold values indicate significant positive or negative correlations.

Abbreviation: BMI, body mass index.

Bone RC Balk RA Cerra FB 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 6 1644 1655 1303622

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