Fat tissue and adiponectin new players in critical care.docVIP

Available online /content/13/4/174 Commentary Fat tissue and adiponectin: new players in critical care? Maciej Owecki Department of Endocrinology, Metabolism and Internal Medicine, University of Medical Sciences in Poznan′, ul. Przybyszewskiego 49, 60-355 Poznan′, Poland Corresponding author: Maciej Owecki, mowecki@.pl Published: 5 August 2009 Critical Care 2009, 13:174 (doi:10.1186/cc7974) This article is online at /content/13/4/174 ? 2009 BioMed Central Ltd See related research by Venkatesh et al., /content/13/4/R105 Abstract serum concentrations of adiponectin have been found to be inversely correlated with insulin resistance in both nonobese and obese subjects and in patients with type 2 diabetes mellitus [11-13]. Historically, adipose tissue was thought to be a passive tissue that stores energy and protects the body from temperature and injury. In contrast to this concept, it is now evident that adipose tissue is an active endocrine organ secreting many kinds of adipocytokines, including adiponectin. Presumably, adipose tissue and its products may have some impact on numerous pathways of response to trauma, sepsis and stress. The discussion on a plausible role of adiponectin in critical illness has been raised by the fact of finding hypoadiponectinemia in critically ill patients. The nature of this phenomenon, however, remains to be elucidated, and noteworthy clinical studies should prompt further efforts in basic research to explain the mechanisms beyond the clinical observation of low adiponectin levels in humans with severe illness. In spite of numerous clinical studies on adiponectin, however, its exact role in metabolism is unclear and remains to be elucidated, along with the as yet unsolved adiponectin paradox: a decreased concentration of adiponectin in obesity seems paradoxical, since fat tissue is the only known source of this protein. In viuew of that