Increased Plasma Adiponectin Levels in Septic Patients with Liver Cirrhosis as an early biomarker

Background Liver cirrhosis is a known risk factor for sepsis and sepsis-related mortality. However, clinical signs of sepsis are often mitigated in patients with liver cirrhosis, leading to delays in diagnosis and treatment. Furthermore, due to liver dysfunction, inflammatory markers may remain low even during infection, complicating the diagnostic process.

Methods The aim of this study was to evaluate plasma levels of adiponectin in patients with liver cirrhosis and patients with sepsis without liver cirrhosis as an early biomarker. Blood samples were collected from patients with various causes of sepsis, and Enzyme-Linked Immunosorbent Assays (ELISA) was used to measure adiponectin levels. A total of 156 blood samples were taken within 24 hours of admission to the intensive care unit.

Results Of the 156 patients, 32 (21%) had liver cirrhosis. Plasma adiponectin levels in septic patients with liver cirrhosis were significantly higher than in septic patients without cirrhosis. A gender-specific analysis revealed that male septic patients with cirrhosis had significantly higher adiponectin levels compared to males without cirrhosis, with a similar trend observed in females. When cirrhotic septic patients were excluded from the analysis, septic patients without cirrhosis had significantly lower plasma adiponectin levels compared to healthy controls.

Conclusion Sepsis can be easily overlooked in patients with liver cirrhosis due to overlapping clinical features. Additionally, the diagnostic utility of traditional inflammatory markers is limited in these patients because of liver dysfunction. Plasma adiponectin may serve as a valuable biomarker for detecting infections in cirrhotic patients and could improve sepsis diagnosis in this high-risk group.

Publication History

Article published online:
20 January 2025