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

Journal article
Authors Margareta Jernås
Bob Olsson
Kajsa Sjöholm
Anders Sjögren
Mats Rudemo
Bengt Nellgård
Lena M S Carlsson
Carl David Sjöström
Published in Metabolism: clinical and experimental
Volume 58
Issue 1
Pages 102-8
ISSN 1532-8600
Publication year 2009
Published at Department of Mathematical Sciences, Mathematical Statistics
Institute of Medicine, Department of Molecular and Clinical Medicine
Institute of Clinical Sciences
Pages 102-8
Language en
Keywords 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
Subject categories Medical and Health Sciences


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.

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