The Effect of Serum Adiponectin and Cortisol Levels on Prognosis in the Patients with Sepsis and Septic Shock
Künye
Demir, H., Toruner, F. B., & Bukan, N. (2021). The effect of serum Adiponectin and cortisol levels on prognosis in the patients with Sepsis and septic shock. Eurasian Journal of Medical Investigation, 5(1), 153.Özet
Objectives: Severe sepsis and septic shock are among the most important causes of death in the intensive care units.
Sepsis is a severe stress condition. Hypothalamic-pituitary-adrenal axis plays an important role in response to stress.
The increase in cortisol level is important in maintaining vascular reactivity, regulating the immune response, and ensuring the balance of the body during acute disease. Adiponectin is an adipocytokine released from adipose tissue,
which is now thought to play a role in the pathogenesis of diseases such as diabetes mellitus, atherosclerosis, malignancy, and sepsis, with its anti-inflammatory, insulin-sensitizing, and anti-atherosclerotic effects. The aim of this study is
to investigate the relationship of cortisol and anti-inflammatory adiponectin, which are effective in the stress response
of the body, with metabolic parameters, inflammation, and prognosis in the patients diagnosed with sepsis.
Methods: Twenty-nine patients who were admitted to Gazi University, Faculty of Medicine Internal Diseases Intensive
Care Unit with the diagnoses of severe sepsis and septic shock, 23 patients who were admitted to the unit for a reason
other than sepsis, and 22 healthy outpatients of similar age were included in the study. Blood samples of the patients
were collected, and their demographic data were recorded during their admission to the intensive care unit.
Results: Although not statistically significant, serum adiponectin level was higher in the septic shock group compared
to the other two groups (p=0.217). Serum adiponectin levels observed after recovering from sepsis were found to
be significantly increased compared to the levels at the time of diagnosis (p<0.001). Serum adiponectin levels were
found to have no significant effect on mortality (p=0.423). Serum cortisol levels were statistically significantly higher
in the patients with sepsis compared to those without sepsis (p=0.0001). In addition, a positive correlation was found
between serum adiponectin level and cortisol (r=0.49, p=0.013). There was also a negative correlation between serum
adiponectin level and C-reactive protein level (r=-0.331, p=0.019).
Conclusion: Our findings suggest that adiponectin plays a role in sepsis as a part of the inflammatory and metabolic
response. Prospective studies examining more cases are needed to use adiponectin as a prognostic marker in the patients with sepsis.