The relationship between Serum Adiponectin and Cortisol levels with inflammation and outcome in septic patients

Sepsis and septic shock are still the most important causes of mortality in intensive care units. For this reason, there is on-going research about new theurapeutic options and markers for diagnosis and prognosis of sepsis.Adiponectin is an adipocytokine which is secreted by adipose tissue and has anti-inflammatory, insulin sensitizing, anti-atherosclerotic effects and plays role in pathogenesis of diseases such as diabetes mellitus, metabolic syndrome, atherosclerosis, malignancy and sepsis.Our study was conducted with 29 patients who were being treated in internal medicine intensive care unit because of sepsis and septic shock, together with 23 patients still in intensive care, but hospitalized for an other reason than sepsis and healthy 24 controls who were being followed in outpatient clinics. Blood samples for clinical tests were taken at the time of admission to intensive care unit before any therapy.There was not any statistically difference in serum adiponectin levels between three groups but adiponectin levels were slightly higher among the patients with septic shock. In patients who recovered from septic shock, adiponectin levels were significanyly higher than the levels measured at the time of admission. According to this information, it was thought that adiponectin might have increased in order to supress the inflammation and restore homeaostasis and patients whose adiponectin levels didn?t increase enough might represent with worse clinical consequences. Moreover, it has been shown in our study that adiponectin levels and mortality don?t have a statistically significiant correlation. Serum adiponectin level had a positive correlation with serum cortisol levels and a negative correlation with serum CRP levels.All these findings have shown that adiponectin is playing role in sepsis as a part of immune and inflammatory response and it may be interpreted as a prognostic marker in septic shock. Our findings also show that we need more clinical studies to validate adiponectin as a prognostic marker and therapeutic target.