Sepsis-Induced Adipokine Change with regard to Insulin Resistance.
Sepsis-Induced Adipokine Change with regard to Insulin Resistance.
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DOI：
10.1155/2012/972368
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发表时间：
2012
影响因子：
2
通讯作者：
Huber-Lang M
中科院分区：
文献类型：
--
作者：
Hillenbrand A;Weiss M;Knippschild U;Wolf AM;Huber-Lang M
背景近年来，对白色脂肪组织的评估发生了变化，WAT现在被认为是一种活跃的内分泌器官，分泌大量生物活性介质，即所谓的脂肪因子。除了其他功能外，这些脂肪因子还参与炎症反应，从而主要表现出促炎或抗炎特性，并导致胰岛素抵抗。方法.使用PubMed检索对脂肪因子在重症监护医学中的作用的文献进行全面综述。结果脂联素-抗炎和胰岛素增敏脂肪因子的原型-在脓毒症中减少，而抵抗素-具有促炎特性的蛋白质-升高。纤溶酶原激活物抑制剂-1、白细胞介素（IL）-1、IL-6、IL-8和IL-10以及肿瘤坏死因子-α介导胰岛素抵抗，并且在脓毒症中升高，而视黄醇结合蛋白-4浓度在脓毒症中显著降低。Chemerin显示出有效的抗炎和胰岛素抵抗特性，而单核细胞趋化蛋白-1在脓毒症中增加，有助于脂肪组织中的巨噬细胞浸润和胰岛素抵抗。结论.脂肪因子在人类中的表达在肥胖和脓毒症患者中也发生改变，促炎性脂肪因子水平升高。急性脓毒症时脂肪因子水平的变化可能与胰岛素抵抗有关。因此，在重症患者中，这些改变强调了脂肪因子在高血糖症发展中的可能作用。
Background. Assessment of white adipose tissue has changed in recent years, with WAT now being considered as an active endocrine organ, secreting a large number of bioactive mediators, so-called adipokines. Besides other functions, these adipokines are involved in inflammatory response thereby exhibiting predominantly proinflammatory or anti-inflammatory properties and contribute to insulin resistance. Methods. Comprehensive review of the literature of the role of adipokines relevant to critical care medicine using PubMed search. Results. Adiponectin—the prototype of an anti-inflammatory and insulin-sensitizing adipokine—is diminished in sepsis, while resistin—a protein with proinflammatory properties—is elevated. Plasminogen activator inhibitor-1, interleukin (IL)-1, IL-6, IL-8, and IL-10, and tumor-necrosis-factor-alpha mediate insulin resistance and are elevated in sepsis, while retinol-binding protein-4 concentrations are significantly reduced in sepsis. Chemerin displays potent anti-inflammatory and insulin-resistance properties, while monocyte chemotactic protein-1—increased in sepsis—contributes to macrophage infiltration in adipose tissue and insulin resistance. Conclusions. The expression of adipokines in humans is altered as well in obese as in septic patients with elevated levels of proinflammatory adipokines. Changes in adipokine levels in acute sepsis could contribute to insulin resistance. Consequently, in critically ill patients, these alterations underline a possible contribution of adipokines in the development of hyperglycemia.