Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Pulmonary Medicine, Amphia Hospital, Breda, The Netherlands.
Int J Obes (Lond). 2023 Feb;47(2):126-137. doi: 10.1038/s41366-022-01246-5. Epub 2022 Dec 12.
Obesity is a risk factor for adverse outcomes in COVID-19, potentially driven by chronic inflammatory state due to dysregulated secretion of adipokines and cytokines. We investigated the association between plasma adipokines and COVID-19 severity, systemic inflammation, clinical parameters, and outcome of COVID-19 patients.
In this multi-centre prospective cross-sectional study, we collected blood samples and clinical data from COVID-19 patients. The severity of COVID-19 was classified as mild (no hospital admission), severe (ward admission), and critical (ICU admission). ICU non-COVID-19 patients were also included and plasma from healthy age, sex, and BMI-matched individuals obtained from Lifelines. Multi-analyte profiling of plasma adipokines (Leptin, Adiponectin, Resistin, Visfatin) and inflammatory markers (IL-6, TNFα, IL-10) were determined using Luminex multiplex assays.
Between March and December 2020, 260 SARS-CoV-2 infected individuals (age: 65 [56-74] BMI 27.0 [24.4-30.6]) were included: 30 mild, 159 severe, and 71 critical patients. Circulating leptin levels were reduced in critically ill patients with a high BMI yet this decrease was absent in patients that were administered dexamethasone. Visfatin levels were higher in critical COVID-19 patients compared to non-COVID-ICU, mild and severe patients (4.7 vs 3.4, 3.0, and 3.72 ng/mL respectively, p < 0.05). Lower Adiponectin levels, but higher Resistin levels were found in severe and critical patients, compared to those that did not require hospitalization (3.65, 2.7 vs 7.9 µg/mL, p < 0.001, and 18.2, 22.0 vs 11.0 ng/mL p < 0.001).
Circulating adipokine levels are associated with COVID-19 hospitalization, i.e., the need for oxygen support (general ward), or the need for mechanical ventilation and other organ support in the ICU, but not mortality.
肥胖是 COVID-19 不良结局的一个危险因素，可能是由于脂肪因子和细胞因子的失调分泌导致慢性炎症状态所致。我们研究了血浆脂肪因子与 COVID-19 严重程度、全身炎症、临床参数和 COVID-19 患者预后之间的关系。
在这项多中心前瞻性横断面研究中，我们收集了 COVID-19 患者的血液样本和临床数据。COVID-19 的严重程度分为轻度（无需住院）、重度（病房住院）和危重症（ICU 住院）。还纳入了 ICU 中非 COVID-19 患者，并从 Lifelines 中获得了年龄、性别和 BMI 匹配的健康个体的血浆。使用 Luminex 多重分析测定血浆脂肪因子（瘦素、脂联素、抵抗素、内脂素）和炎症标志物（IL-6、TNFα、IL-10）的多分析物谱。
2020 年 3 月至 12 月期间，共纳入 260 例 SARS-CoV-2 感染患者（年龄：65 [56-74] BMI 27.0 [24.4-30.6]）：30 例轻度、159 例重度和 71 例危重症患者。危重症高 BMI 患者的循环瘦素水平降低，但接受地塞米松治疗的患者则无此降低。与非 COVID-ICU、轻度和重度患者相比，危重症 COVID-19 患者的内脂素水平更高（4.7 与 3.4、3.0 和 3.72ng/mL，p<0.05）。与无需住院治疗的患者相比，重症和危重症患者的脂联素水平较低，抵抗素水平较高（3.65、2.7 与 7.9μg/mL，p<0.001，和 18.2、22.0 与 11.0ng/mL，p<0.001）。
循环脂肪因子水平与 COVID-19 住院相关，即需要氧支持（普通病房）或需要机械通气和 ICU 中的其他器官支持，但与死亡率无关。
