ARDS is pathologically characterized by an uncontrolled inflammatory response and widespread alveolar-endothelial injury.1 As a novel biomarker for endothelial damage and obesity-related vascular diseases in human study,24, 26, 28 omentin has also been shown to be involved in modulating inflammation, apoptosis and angiogenesis in experimental studies.37, 38, 39 All these underlying mechanisms were implicated in the pathogenesis of ARDS; the anti-inflammatory and endothelial-protective properties of omentin were elucidated in our present study. Here, ITLN1 is linked to acute respiratory distress syndrome.