Tissue Lipolysis Vs Tissue Cortisol in Septic and Non-Septic Critical Illness

Program: Abstracts - Orals, Poster Preview Presentations, and Posters
Session: SUN 0875-0890-Adipocyte Biology-Clinical studies
Sunday, June 22, 2014: 1:00 PM-3:00 PM
Hall F (McCormick Place West Building)

Poster Board SUN-0881
Ioannis Ilias, MD, PHD1, Dimitra A Vassiliadi, MD, PhD2, Maria Theodorakopoulou, MD2, Nikitas Nikitas, MD2, Marinela Tzanela, MD, PhD3, Sofia Apollonatou, MD2, Stylianos Tsagarakis, MD, PHD, FRCP4 and Ioanna Dimopoulou, MD, PHD2
1E Venizelou Hosp, Athens, Greece, 2University of Athens Medical School, Athens, Greece, 3Evangelismos Hospital, Athens, Greece, 4Evangelisnos Hospital, Athens, Greece
Introduction: Cortisol (F) is enmeshed in adipose tissue metabolism in many aspects (1). A positive association between plasma F and lipolysis has been observed. Critically ill patients show the “lipemia of sepsis”.

Aim: To study, in septic and non-septic ICU patients, adipose tissue lipolysis vs tissue F, using microdialysis (MD).

Subjects and methods: We studied 43 (24 men & 19 women, mean age±SD: 63±19 years) mechanically ventilated patients with a diagnosis of septic shock (n=21) or systemic inflammatory response syndrome/severe sepsis (n=22). Upon ICU admission a MD catheter was inserted under sterile conditions into the subcutaneous adipose tissue of the upper thigh. Excluding patients on steroid therapy, on day 2 (n=27), day 3 (n=24) and day 4 (n=21) MD samples were collected six times per day for MD glycerol (MD GLYC; used as an index of lipolysis) and tissue F. The mean of these 6 collections was used for analysis (normal values for adipose tissue GLYC glycerol < 200 μmol/L). Statistics were done with analysis of covariance (ANCOVA) and linear regression.

Results: Most samplings (44/72) indicated accentuated lipolysis with above-normal MD GLYC levels. MD GLYC was associated with MD F (ANCOVA p=0.022) and was not associated with age, day of sampling or presence of shock. MD GLYC was weakly correlated to MD F (r=+0.242, p=0.045).

Discussion: Changes in interstitial/tissue F may not be reflected in plasma (total) F concentration (2). Thus it is interesting that we observed an - albeit weak - association between tissue lipolysis (via MD GLYC levels) and MD F, verifying (though modestly so) the well-known association between lipolysis and F (3).

(1) Gathercole L.L., et al. PLoS ONE 2011; 6: e26223 (2) Vassiliadi D.A., et al J Crit Care 2013; 28: 158-165 (3) Djurhuus C.B., et al. Am J Physiol Endocrinol Metab 2002; 283: E172-E177

Nothing to Disclose: II, DAV, MT, NN, MT, SA, ST, ID

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