Increased subcutaneous and epicardial adipose tissue production of proinflammatory cytokines in cardiac surgery patients: possible role in postoperative insulin resistance
Language English Country United States Media print-electronic
Document type Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
PubMed
16895955
DOI
10.1210/jc.2006-1044
PII: jc.2006-1044
Knihovny.cz E-resources
- MeSH
- Anti-Inflammatory Agents blood metabolism MeSH
- Adipose Tissue, White metabolism MeSH
- Biomarkers blood MeSH
- Cytokines biosynthesis physiology MeSH
- Hormones blood metabolism MeSH
- Thoracic Surgery * MeSH
- Hyperglycemia blood drug therapy etiology MeSH
- Immunocompetence physiology MeSH
- Infusion Pumps MeSH
- Insulin administration & dosage blood MeSH
- Insulin Resistance physiology MeSH
- Blood Glucose analysis MeSH
- Middle Aged MeSH
- Humans MeSH
- Inflammation Mediators metabolism physiology MeSH
- RNA, Messenger metabolism MeSH
- Pericardium cytology MeSH
- Subcutaneous Fat metabolism MeSH
- Postoperative Period MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Anti-Inflammatory Agents MeSH
- Biomarkers MeSH
- Cytokines MeSH
- Hormones MeSH
- Insulin MeSH
- Blood Glucose MeSH
- Inflammation Mediators MeSH
- RNA, Messenger 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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