Introduction: Omentin-1, a novel adipokine with anti-inflammatory properties, has not been studied in sepsis.

Aims and objectives: To investigate the association of serum omentin-1 early in sepsis with sepsis outcome in critically ill patients.

Methods: In a prospective study, 102 critically ill patients with new onset sepsis were enrolled (57 males, age 64.7±15.6 years, APACHE II 23±7.2, SOFA 10±3.3) and serum omentin-1 was determined at sepsis onset and one week after. Patients were followed for 28 days.

Results: Thirty patients died within 28 days after sepsis onset.  Serum omentin-1 was significantly higher in nonsurvivors compared to survivors at enrollment (952.1 ± 248.2 vs. 684.6 ± 204.7 ?g/L, p<0.001) and one week after (1051.8 ± 242 vs. 908.4 ± 189.8 ?g/L, p<0.01). While omentin-1 increased significantly one week after sepsis onset in both groups (p<0.001), survivors had a greater mean increase (223.8 ± 147.9 ?g/L vs. 99.6 ± 111.3 ?g/L, p<0.001), and percentage change from baseline (?(omentin-1)% 39.4 ± 34.3% vs. 13.3 ± 18.1%, p<0.001) compared to nonsurvivors. Kaplan-Meier survival curves showed that patients with lower omentin-1 at sepsis onset and one-week after as well as those with a higher percentage change from baseline had improved 28-day survival (p<0.001). Higher serum omentin-1 at sepsis onset and one week later was independently associated with 28-day mortality, after adjustment for the APACHE II score (sepsis onset: HR 2.26, 95%C.I. 1.21?4.19, p=0.01; one week after: HR 2.15, 95%C.I. 1.43?3.22, p<0.001).

Conclusions: Higher serum omentin-1 early in sepsis as well as its lower kinetics during the first week of sepsis is associated with a poor outcome in critically ill patients.