Increased subcutaneous and epicardial adipose tissue production of proinflammatory cytokines in cardiac surgery patients: possible role in postoperative insulin resistance
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu klinické zkoušky, časopisecké články, práce podpořená grantem
PubMed
16895955
DOI
10.1210/jc.2006-1044
PII: jc.2006-1044
Knihovny.cz E-zdroje
- MeSH
- antiflogistika krev metabolismus MeSH
- bílá tuková tkáň metabolismus MeSH
- biologické markery krev MeSH
- cytokiny biosyntéza fyziologie MeSH
- hormony krev metabolismus MeSH
- hrudní chirurgie * MeSH
- hyperglykemie krev farmakoterapie etiologie MeSH
- imunokompetence fyziologie MeSH
- infuzní pumpy MeSH
- inzulin aplikace a dávkování krev MeSH
- inzulinová rezistence fyziologie MeSH
- krevní glukóza analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mediátory zánětu metabolismus fyziologie MeSH
- messenger RNA metabolismus MeSH
- perikard cytologie MeSH
- podkožní tuk metabolismus MeSH
- pooperační období MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antiflogistika MeSH
- biologické markery MeSH
- cytokiny MeSH
- hormony MeSH
- inzulin MeSH
- krevní glukóza MeSH
- mediátory zánětu MeSH
- messenger RNA MeSH
CONTEXT: Hyperglycemia and insulin resistance frequently occur in critically ill patients even without a history of diabetes. OBJECTIVE: Our objective was to study the role of adipose tissue hormonal production in the development of insulin resistance in cardiac surgery patients. PARTICIPANTS, INTERVENTIONS, AND SETTINGS: Fifteen patients with elective cardiac surgery underwent blood sampling before, at the end, and 6, 12, 24, 48, and 120 h after the end of their operation. Epicardial and sc adipose tissue sampling was done at the beginning and at the end of surgery in the Department of Cardiac Surgery. MAIN OUTCOME MEASURES: We measured serum concentrations and sc and epicardial adipose tissue mRNA expression of IL-6, monocyte chemoattractant protein-1 (MCP-1), TNF-alpha, leptin, resistin, and adiponectin and sc and epicardial adipose tissue mRNA expression of CD14, CD45, and CD68. RESULTS: The rate of insulin infusion required to maintain euglycemia increased up to 7-fold 12 h after the operation, suggesting the development of insulin resistance. Serum IL-6 levels increased 43-fold 12 h after surgery. MCP-1 peaked 6-fold at the end of surgery. Smaller peaks of TNF-alpha and leptin appeared 6 and 12 h after surgery, respectively. Resistin levels peaked 4-fold 24 h after surgery, but adiponectin levels were not significantly affected. TNF-alpha and CD45 mRNA expression increased markedly during the operation in sc adipose tissue. IL-6, resistin, and MCP-1 mRNA expression increased in both sc and epicardial adipose tissue. Leptin, adiponectin, CD14, and CD68 mRNA expression did not change significantly. CONCLUSIONS: Both sc and epicardial adipose tissue is a source of proinflammatory cytokines in cardiac surgery patients and may contribute to the development of postoperative insulin resistance.
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