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J Crit Care. 2014 Oct;29(5):723-7. doi: 10.1016/j.jcrc.2014.04.018. Epub 2014 Apr 24.

Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis.

Author information

1
Section of Infectious Diseases, Patras University Hospital, 26442 Patras, Greece. Electronic address: alekkou@yahoo.gr.
2
Division of Hematology, Department of Internal Medicine, Patras University Hospital, School of Medicine, 26504 Patras, Greece.
3
Department of Internal Medicine, Patras University Hospital, 26504 Patras, Greece.
4
Intensive Care Unit, Agios Andreas Hospital, 26335 Patras, Greece.
5
Section of Infectious Diseases, Patras University Hospital, School of Medicine, 26504 Patras, Greece.

Abstract

PURPOSE:

The purpose of the study is to evaluate the prevalence and clinical significance of hypolipidemia and the relationship to cytokine concentrations and outcomes in septic patients.

MATERIALS AND METHODS:

A prospective study was undertaken including 50 patients with severe sepsis due to community-acquired infections. Serum concentrations of total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein as well as tumor necrosis factor α (TNF-α), interleukin (IL) 6, IL-8, IL-10, and transforming growth factor (TGF) β1 were determined on admission and days 3 and 10 during hospitalization.

RESULTS:

Of the 50 patients enrolled, 28 survived, whereas 22 died during their hospital stay. Sepsis survivors had significantly higher HDL-C concentrations than nonsurvivors, whereas all patients with HDL-C values greater than 25 mg/dL survived. Baseline levels of TGF-β1 were significantly higher in survivors. High-density lipoprotein levels correlated inversely with TNF-α, IL-6, and IL-10 concentrations and positively with baseline TGF-β1 levels. Independent risk factors of mortality were IL-10 levels on day 3, whereas HDL-C concentration on admission was related to survival.

CONCLUSIONS:

Low cholesterol and lipoprotein concentrations are detected in septic patients, especially in individuals with poor outcome. High-density lipoprotein cholesterol concentration seems to be an early independent predictive marker of survival in severe sepsis.

KEYWORDS:

Cytokines; High-density lipoprotein; Lipoproteins; Sepsis; Transforming growth factor (TGF) β(1)

PMID:
24891152
DOI:
10.1016/j.jcrc.2014.04.018
[Indexed for MEDLINE]
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