Adipokine Dynamics in Critical Illness and Metabolic Disorders

Adipose tissue functions as an active endocrine organ, secreting a diverse array of bioactive molecules termed adipokines. These factors, including adiponectin, leptin, resistin and others, exert profound effects on metabolic regulation, immune modulation and vascular homeostasis. In the context of critical illness—such as systemic inflammatory response syndrome and sepsis—adipokine production and circulating levels undergo marked perturbations, reflecting and influencing the host’s inflammatory and metabolic state. Critically ill patients often exhibit decreased adiponectin, an anti-inflammatory and insulin-sensitising adipokine, alongside elevated pro-inflammatory peptides, contributing to insulin resistance, endothelial dysfunction and altered immune responses. Conversely, chronic metabolic disorders such as obesity, type 2 diabetes and metabolic syndrome are characterised by low adiponectin, high leptin and resistin levels, perpetuating chronic low-grade inflammation and impaired metabolic homeostasis. Emerging evidence indicates that fluctuations in adipokines not only mirror disease severity but also hold prognostic significance and therapeutic potential. Understanding these dynamic shifts offers insights into the interplay between metabolism and immunity, guiding the development of novel biomarkers and interventions for both acute and chronic metabolic pathologies.

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Adipokine Dynamics in Critical Illness and Metabolic Disorders publication trend

The graph below shows the total number of articles in adipokine dynamics in critical illness and metabolic disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Adipokine: A bioactive peptide or protein secreted by adipose tissue, involved in metabolic and inflammatory regulation.

Adiponectin: An anti-inflammatory, insulin-sensitising adipokine predominantly produced by adipocytes, protective against metabolic and vascular disorders.

Leptin: An adipose-derived hormone that regulates energy balance, satiety and immune function, often elevated in obesity and inflammation.

Resistin: An adipokine linked to insulin resistance and pro-inflammatory responses, primarily secreted by macrophages in humans.

Insulin resistance: A state in which target tissues exhibit diminished response to insulin, leading to impaired glucose uptake and metabolic dysregulation.

Systemic inflammatory response syndrome (SIRS): A clinical condition characterised by widespread inflammation affecting the whole body, often preceding sepsis.

Sepsis: A life-threatening organ dysfunction caused by a dysregulated host response to infection.

Metabolic syndrome: A cluster of conditions including central obesity, dyslipidaemia, hypertension and insulin resistance, increasing cardiovascular risk.

References

1. Exploring the Relationship between Plasma Adiponectin, Gender, and Underlying Diseases in Severe Illness. Biomedicines (2023).
2. Clinical review: Adiponectin biology and its role in inflammation and critical illness. Critical Care (2011).
3. Multiple sclerosis and obesity: The role of adipokines. Frontiers in Immunology (2022).
4. Adiponectin is protective against endoplasmic reticulum stress-induced apoptosis of endothelial cells in sepsis. Brazilian Journal of Medical and Biological Research (2018).
5. Circulating adipokine levels and prognostic value in septic patients. Journal of Inflammation (2016).