Changes in adipose tissue gene expression and plasma levels of adipokines and acute-phase proteins in patients with critical illness.

• Insulin resistance develops rapidly during critical illness. The release of adipokines from adipose tissue is thought to play a key role in the development of insulin resistance, as are elevated levels of acute-phase proteins. The aim of this study was to identify changes in adipose tissue gene expression and plasma levels of adipokines and acute-phase proteins during critical illness. From 8 patients with subarachnoidal hemorrhage, consecutive blood samples and adipose tissue biopsies were obtained at 3 time points, twice during intensive care (1-2 days [IC1] and 7-9 days after subarachnoidal hemorrhage) and once after 8 months (recovery). The patients received a continuous insulin infusion to maintain normal glucose levels reflecting insulin resistance. The DNA microarray analysis showed increased zink-alpha2 glycoprotein (ZAG) and phospholipase A2, group IIA messenger RNA levels during intensive care compared with recovery (P < .05). Real-time polymerase chain reaction confirmed the increased expression of ZAG and phospholipase A2, group IIA. Plasma levels of ZAG, serum amyloid A, and C-reactive protein were higher at 7 to 9 days after subarachnoidal hemorrhage compared with either IC1 or recovery (P = .0001); and plasma levels of retinol-binding protein 4 and adiponectin were lower at IC1 compared with recovery (P = .05). The described changes in adipose tissue gene expression and plasma levels of adipokines and acute-phase proteins may influence the development of insulin resistance during critical illness.

Keyword

Acute-Phase Proteins

genetics

metabolism

Adipokines

biosynthesis

blood

genetics

Adipose Tissue

metabolism

physiology

Biopsy

Blood Glucose

metabolism

Critical Illness

Female

Gene Expression Regulation

Humans

Insulin

therapeutic use

Insulin Resistance

genetics

physiology

Male

Middle Aged

Oligonucleotide Array Sequence Analysis

RNA

chemistry

genetics

Reverse Transcriptase Polymerase Chain Reaction

Subarachnoid Hemorrhage

blood

genetics

genetics

Publication and Content Type

ref (subject category)

art (subject category)