Adipokines in critically ill patients: A systematic review and meta-analysis of observational studies

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-04-22 DOI:10.1016/j.clnesp.2025.03.176

Ahmadreza Kolahi , Mohammad Gholizadeh , Sakineh Shab-Bidar

{"title":"Adipokines in critically ill patients: A systematic review and meta-analysis of observational studies","authors":"Ahmadreza Kolahi , Mohammad Gholizadeh , Sakineh Shab-Bidar","doi":"10.1016/j.clnesp.2025.03.176","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Critical illness is a hypermetabolic state with high mortality rates. Adipokines, including leptin, adiponectin, and resistin, regulate energy balance, inflammation, and metabolism and may influence outcomes in critically ill patients. This study evaluated changes in adipokine levels in ICU patients compared to healthy controls and explored their associations with clinical outcomes.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of 34 case–control studies involving 3365 participants were conducted. Pooled weighted mean difference (WMD) of adipokine levels between critically ill patients and controls were calculated using random-effects models. Subgroup analyses were performed based on ICU type (Medical, Surgical, Mixed), septic status (septic or non-septic), and injury phase (ebb or flow). Publication bias and sensitivity analyses were also conducted.</div></div><div><h3>Results</h3><div>Leptin (WMD: 3.22 ng/mL; 95 % CI: 0.91 to 5.53) and resistin (WMD: 19.86 ng/mL; 95 % CI: 14.78 to 24.95) levels were significantly elevated in critically ill patients, while adiponectin levels showed no significant difference (WMD: 0.37 μg/dL; 95 % CI: −1.81 to 2.55). Subgroup analyses revealed higher leptin and resistin levels in mixed-ICU and septic patients. Leptin also increased during the ebb phase, but heterogeneity remained high (I<sup>2</sup> > 97 %).</div></div><div><h3>Conclusions</h3><div>Leptin and resistin levels are elevated in critical illness, potentially serving as biomarkers for disease severity. However, high heterogeneity limits generalizability. Future research should standardize protocols and investigate adipokines’ prognostic and therapeutic roles in critical care.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"68 ","pages":"Pages 216-227"},"PeriodicalIF":2.9000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405457725002670","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Critical illness is a hypermetabolic state with high mortality rates. Adipokines, including leptin, adiponectin, and resistin, regulate energy balance, inflammation, and metabolism and may influence outcomes in critically ill patients. This study evaluated changes in adipokine levels in ICU patients compared to healthy controls and explored their associations with clinical outcomes.

Methods

A systematic review and meta-analysis of 34 case–control studies involving 3365 participants were conducted. Pooled weighted mean difference (WMD) of adipokine levels between critically ill patients and controls were calculated using random-effects models. Subgroup analyses were performed based on ICU type (Medical, Surgical, Mixed), septic status (septic or non-septic), and injury phase (ebb or flow). Publication bias and sensitivity analyses were also conducted.

Results

Leptin (WMD: 3.22 ng/mL; 95 % CI: 0.91 to 5.53) and resistin (WMD: 19.86 ng/mL; 95 % CI: 14.78 to 24.95) levels were significantly elevated in critically ill patients, while adiponectin levels showed no significant difference (WMD: 0.37 μg/dL; 95 % CI: −1.81 to 2.55). Subgroup analyses revealed higher leptin and resistin levels in mixed-ICU and septic patients. Leptin also increased during the ebb phase, but heterogeneity remained high (I² > 97 %).

Conclusions

Leptin and resistin levels are elevated in critical illness, potentially serving as biomarkers for disease severity. However, high heterogeneity limits generalizability. Future research should standardize protocols and investigate adipokines’ prognostic and therapeutic roles in critical care.

查看原文本刊更多论文

危重病人的脂肪因子：观察性研究的系统回顾和荟萃分析。

背景：危重症是一种高代谢状态，死亡率高。脂肪因子，包括瘦素、脂联素和抵抗素，调节能量平衡、炎症和代谢，并可能影响危重患者的预后。本研究评估了ICU患者与健康对照组相比脂肪因子水平的变化，并探讨了其与临床结果的关系。方法：对34项病例对照研究进行系统回顾和荟萃分析，共纳入3365名受试者。使用随机效应模型计算危重患者和对照组之间脂肪因子水平的加权平均差异（WMD）。根据ICU类型（内科、外科、混合）、脓毒症状态（脓毒症或非脓毒症）和损伤阶段（潮起潮落）进行亚组分析。还进行了发表偏倚和敏感性分析。结果：瘦素(WMD: 3.22 ng/mL；95% CI: 0.91 ~ 5.53)和抵抗素(WMD: 19.86 ng/mL；95% CI: 14.78 ~ 24.95)，重症患者脂联素水平显著升高，而脂联素水平无显著差异(WMD: 0.37 μg/dL；95% CI: -1.81至2.55)。亚组分析显示，混合icu和脓毒症患者瘦素和抵抗素水平较高。在退潮期，瘦素也有所增加，但异质性仍然很高（2% ~ 97%）。结论：瘦素和抵抗素水平在危重疾病中升高，可能作为疾病严重程度的生物标志物。然而，高异质性限制了通用性。未来的研究应规范方案，并调查脂肪因子在重症监护中的预后和治疗作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.