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The metabolic syndrome in critically ill patients
Authors:Robinson Katherine  Kruger Peter  Prins John  Venkatesh Bala
Affiliation:aDepartment of Intensive Care, Wesley Hospital, University of Queensland, Australia;bDepartment of Intensive Care, Princess Alexandra Hospital, University of Queensland, Australia;cDepartment of Endocrinology Mater Medical Research Institute, University of Queensland, Australia
Abstract:Metabolic support in intensive care is a rapidly evolving field with new information being gathered almost on a daily basis. In endocrine practice, over the last 20 years, researchers have focussed on a new entity, termed the "metabolic syndrome". This describes the constellation of abnormalities which include central adiposity, insulin resistance and inflammation. All of these predispose the individual to a greater risk of cardiovascular events. Of interest is the observation that some of the metabolic abnormalities in sepsis and multiple organ dysfunction syndrome of critical illness share several common features with that of the metabolic syndrome. In this chapter we describe the features of the metabolic syndrome as is understood in endocrine parlance, the metabolic abnormalities of critical illness and explore the common threads underlying the pathophysiology and the treatment of the two syndromes. The role of adiponectin in the metabolic abnormalities in both the metabolic syndrome and in sepsis are reviewed. The potential role of the pleiotropic effects of statins in the therapy of sepsis is also discussed.
Keywords:metabolic syndrome   sepsis   inflammation   adiponectin   statins
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