Department of Emergency Medicine and Critical Care Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Dis Markers. 2020 Jan 14;2020:9608276. doi: 10.1155/2020/9608276. eCollection 2020.
Adipokines are a group of cytokines or peptides secreted by adipose tissue to exert numerous biological functions. In the present study, we measured the plasma levels of four adipokines (adiponectin, leptin, fatty acid-binding protein 4 (FABP4), and visfatin) in cardiac arrest patients following return of spontaneous circulation (ROSC).
Totally, 21 patients who experienced cardiac arrest and successful ROSC with expected survival of at least 48 hours (from January 2016 to December 2017) were consecutively enrolled into this prospective observational clinical study. Of the 21 enrolled patients, ten survived, and other eleven died between 2 days and 6 months post ROSC. Venous blood was drawn at three time points: baseline (<1 hour post ROSC), 2 days post ROSC, and 7 days post ROSC. Plasma concentrations of adiponectin, leptin, FABP4, and visfatin were determined using commercial enzyme-linked immunosorbent assays.
The plasma visfatin levels at 2 or 7 days post ROSC increased significantly compared with the baseline ( < 0.01), while plasma levels of adiponectin, leptin, and FABP4 did not change. Moreover, plasma visfatin levels in survivors at 2 or 7 days post ROSC were higher than those in nonsurvivors ( < 0.01). Plasma visfatin levels at 2 or 7 days post ROSC were negatively correlated with Acute Physiology and Chronic Health Evaluation (APACHE) II score and time to ROSC. Moreover, receiver operating characteristic curve analysis showed that the plasma visfatin levels at 2 or 7 days post ROSC were good predictors for survival of the patients.
Elevated plasma visfatin levels may be a marker for better outcome of cardiac arrest patients post ROSC.
脂肪因子是一组由脂肪组织分泌的细胞因子或肽，具有多种生物学功能。本研究测量了自主循环恢复（ROSC）后心脏骤停患者的四种脂肪因子（脂联素、瘦素、脂肪酸结合蛋白 4（FABP4）和内脂素）的血浆水平。
连续纳入 2016 年 1 月至 2017 年 12 月期间经历心脏骤停并成功 ROSC、预计至少存活 48 小时的 21 例患者，纳入本前瞻性观察性临床研究。21 例患者中，10 例存活，其余 11 例在 ROSC 后 2 天至 6 个月内死亡。静脉血在三个时间点采集：基线（ROSC 后<1 小时）、ROSC 后 2 天和 7 天。使用商业酶联免疫吸附试验测定血浆脂联素、瘦素、FABP4 和内脂素浓度。
与基线相比，ROSC 后 2 天或 7 天的血浆内脂素水平显著升高（<0.01），而脂联素、瘦素和 FABP4 水平没有变化。此外，ROSC 后 2 天或 7 天幸存者的血浆内脂素水平高于非幸存者（<0.01）。ROSC 后 2 天或 7 天的血浆内脂素水平与急性生理和慢性健康评估（APACHE）Ⅱ评分和 ROSC 时间呈负相关。此外，ROC 曲线分析显示，ROSC 后 2 天或 7 天的血浆内脂素水平是患者生存的良好预测指标。
升高的血浆内脂素水平可能是 ROSC 后心脏骤停患者更好预后的标志物。
