Adipose Tissue and Endocrine Function in Critical Care

  • Mirna Marques
  • Lies LangoucheEmail author
Living reference work entry


In addition to energy storage and insulation, the white adipose tissue is a complex endocrine organ responsible for the secretion of a high number of adipocyte-originated signaling molecules. These so-called adipokines are involved in the control of metabolism, linking the nutrient status to the tissues involved in energy intake and expenditure and affecting insulin sensitivity. Additionally, resident and recruited macrophages constitute an important part of the adipose tissue, responsible for the secretion of inflammatory and anti-inflammatory cytokines. Up until now, more than 40 different adipokines have been described. From these, leptin and adiponectin are the most studied during critical illness.

Although knowledge is still limited, current available literature suggests that the endocrine functions of adipose tissue might play an adaptive role during critical illness. In the acute phase of illness, the anti-inflammatory and insulin-sensitizing adiponectin is reduced, while pro-inflammatory cytokine expression in adipose tissue is upregulated. In the prolonged phase of critical illness, both adiponectin and anti-inflammatory cytokine production are increasing. Reports on the pro-inflammatory leptin during critical illness are controversial in both humans and animal investigations, possibly due to confounders such as gender, body mass index, and nutritional strategy.

Observational studies report lower mortality in obese than in lean critically ill patients, an association referred to as the “obesity paradox.” Potentially, the altered adipokine secretion profile observed in obesity plays a protective role during critical illness.


Adipose Tissue Critical Illness White Adipose Tissue Adiponectin Level Visceral Adipose Tissue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Adiponectin receptor


Acute respiratory distress syndrome


C-X-C motif chemokine 10


EGF-like module-containing mucin-like hormone receptor


High molecular weight






Low molecular weight




Monocyte chemoattractant protein-1


Medium molecular weight


Plasminogen activator inhibitor-1


Peroxisome proliferator-activated receptor γ


Retinol-binding protein 4


Reactive oxygen species


Tumor necrosis factor-alpha


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© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Cellular and Molecular MedicineUniversity of Leuven (KU Leuven), Laboratory of Intensive Care MedicineLeuvenBelgium

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