Article

Plasma concentrations of adipocyte fatty acid binding protein in patients with Cushing's syndrome.

Third Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
Physiological research / Academia Scientiarum Bohemoslovaca (Impact Factor: 1.53). 01/2010; 59(6):963-71.
Source: PubMed

ABSTRACT Serum adipocyte fatty acid-binding protein (FABP-4) concentrations are linked to human obesity and other features of metabolic syndrome. Patients with Cushing´s syndrome (CS) develop numerous features of metabolic syndrome due to chronic cortisol excess. Here we tested the hypothesis that chronically increased cortisol levels in CS patients may alter circulating levels of FABP-4. Fourteen patients with CS, 19 patients with simple obesity (OB) and 36 healthy control subjects (C) were included in the study. Serum FABP-4 concentrations were significantly higher in both CS and OB patients relative to C group, but they did not differ between CS and OB groups. In a combined population of all groups, serum FABP-4 levels correlated positively with BMI, body fat content, serum glucose, triglycerides, HbA1c and HOMA index and were inversely related to HDL-cholesterol, resting energy expenditure and freeT3 levels. We conclude that FABP-4 levels are significantly increased in both patients with simple obesity and obese patients with Cushing´s syndrome. We suggest that increased FABP-4 concentrations in CS patients are rather due to their excessive fat accumulation and related metabolic abnormalities than due to a direct effect of cortisol on FABP-4 production.

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    ABSTRACT: Introduction Hyperglycemia and insulin resistance are commonplace in critical illness, especially in patients with sepsis. Recently, several hormones secreted by adipose tissue have been identified to be involved in overall insulin sensitivity in metabolic syndrome-related conditions, including adipocyte fatty-acid binding protein (A-FABP). However, little is known about their roles in critical illness. On the other hand, there is evidence that several adipose tissue gene expressions change in critical illness patients. Methods A total of 120 patients (72 with sepsis, 48 without sepsis) were studied prospectively at the admission to medical intensive care unit and compared with 45 healthy volunteers as controls. Various laboratory parameters, metabolic and inflammatory profiles were assessed within 48 h after admission. Clinical data were collected from medical records. Results Compared with healthy controls, serum A-FABP concentrations were higher in all critical illness patients, and a trend of higher A-FABP in patient with sepsis. In multivariate correlation analysis in all critical illness patients, the serum A-FABP concentrations were independently related to serum creatinine, fasting plasma glucose, total cholesterol, TNF-alpha, albumin, and the Acute Physiology and Chronic Health Evaluation II scores. In survival analysis, higher A-FABP levels (> 40 ng/ml) were associated with an unfavorable outcome on the overall survival, especially in sepsis patients. Conclusions Critical illness patients have higher serum A-FABP concentrations. Moreover, A-FABP may potentially serve as a prognostic biomarker in critically ill patients with sepsis.
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