Adipocytokine plasma concentrations reflect influence of inflammation but not body mass index (BMI) on clinical outcomes of COVID-19 patients: A prospective observational study from the Netherlands.
Aline H de NooijerEmma J KooistraInge GrondmanNico A F JanssenLeo A B JoostenFrank L van de VeerdonkMatthijs KoxPeter PickkersMihai M Neteanull nullPublished in: Clinical obesity (2022)
Obesity is recognized as a risk factor for adverse outcome in COVID-19, but the molecular mechanisms underlying this relationship remain unknown. Adipose tissue functions as an endocrine organ by secreting multiple pro-inflammatory and anti-inflammatory factors, known as adipocytokines, which could be involved in COVID-19 severity. We explored the role of adipocytokines in COVID-19 and its association with BMI, clinical outcome, and inflammation. This is an observational study in 195 hospitalized COVID-19 patients. Serial plasma concentrations of the adipocytokines leptin, adiponectin, resistin, and various inflammatory cytokines were assessed. Adipocytokines were compared between patients with normal weight (BMI: 18.5-24.9 kg/m 2 ), overweight (BMI: 25.0-29.9 kg/m 2 ), and obesity (BMI ≥ 30 kg/m 2 ), between patients admitted to the ICU and to non-ICU clinical wards, and between survivors and non-survivors. Patients with overweight and obesity displayed higher leptin concentrations and lower adiponectin concentrations throughout hospital admission (p < .001), whereas resistin concentrations were not different from patients with normal weight (p = .12). Resistin concentrations correlated with inflammatory markers and were persistently higher in ICU patients and non-survivors compared to non-ICU patients and survivors, respectively (both p < .001), whereas no such relationships were found for the other adipocytokines. In conclusion, leptin and adiponectin are associated with BMI, but not with clinical outcomes and inflammation in COVID-19 patients. In contrast, resistin is not associated with BMI, but high concentrations are associated with worse clinical outcomes and more pronounced inflammation. Therefore, it is unlikely that BMI-related adipocytokines or differences in the inflammatory response underlie obesity as a risk factor for severe COVID-19.
Keyphrases
- body mass index
- weight gain
- sars cov
- insulin resistance
- coronavirus disease
- metabolic syndrome
- weight loss
- end stage renal disease
- oxidative stress
- intensive care unit
- adipose tissue
- physical activity
- inflammatory response
- young adults
- type diabetes
- ejection fraction
- chronic kidney disease
- anti inflammatory
- newly diagnosed
- healthcare
- peritoneal dialysis
- mechanical ventilation
- high fat diet
- high fat diet induced
- magnetic resonance
- emergency department
- magnetic resonance imaging
- skeletal muscle
- lps induced
- acute care
- acute respiratory distress syndrome