tailieunhanh - Báo cáo y học: "Circulating retinol binding protein 4 in critically ill patients before specific treatment: prognostic impact and correlation with organ function, metabolism and inflammation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Circulating retinol binding protein 4 in critically ill patients before specific treatment: prognostic impact and correlation with organ function, metabolism and inflammation. | Koch et al. Critical Care 2010 14 R179 http content 14 5 R179 c CRITICAL CARE RESEARCH Open Access Circulating retinol binding protein 4 in critically ill patients before specific treatment prognostic impact and correlation with organ function metabolism and inflammation 12 1 11 Alexander Koch Ralf Weiskirchen Edouard Sanson Henning W Zimmermann Sebastian Voigt Hanna Duckers1 Christian Trautwein1 Frank Tacke1 Abstract Introduction Hyperglycemia and insulin resistance are well-known features of critical illness and impact the mortality rate especially in sepsis. Retinol binding protein 4 RBP4 promotes insulin resistance in mice and is systemically elevated in patients with obesity and type 2 diabetes. We investigated the potential role of RBP4 in critically ill patients. Methods We conducted a prospective single-center study of serum RBP4 concentrations in critically ill patients. One hundred twenty-three patients 85 with sepsis 38 without sepsis were studied at admission to a medical intensive care unit ICU before initiation of specific intensive care treatment measures and compared to 42 healthy nondiabetic controls. Clinical data various laboratory parameters and metabolic and endocrine functions were assessed. Patients were followed for approximately 3 years. Results Serum RBP4 was significantly reduced in ICU patients independently of sepsis as compared to healthy controls P . Patients with liver cirrhosis as the primary underlying diagnosis for ICU admission had significantly lower RBP4 levels as compared with other ICU patients. Accordingly in all ICU patients serum RBP4 closely correlated with liver function and increased with renal failure. No significant differences of serum RBP4 concentrations in septic patients with pulmonary or other origins of sepsis or nonseptic patients could be revealed. Acute phase proteins were inversely correlated with RBP4 in sepsis patients. RBP4 did not differ between patients with or without obesity or .