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Prognostic Implications of Serum Lipid Metabolism over Time during Sepsis.

Lee SH, Park MS, Park BH, Jung WJ, Lee IS, Kim SY, Kim EY, Jung JY, Kang YA, Kim YS, Kim SK, Chang J, Chung KS - Biomed Res Int (2015)

Bottom Line: Nonsurvivors had low levels of cholesterol, TG, HDL, LDL, and Apo A-I on days 0, 1, 3, and 7.In a linear mixed model analysis, the variations in TG, LDL, FFA, and Apo A-I levels over time differed significantly between the groups (p = 0.043, p = 0.020, p = 0.005, and p = 0.015, resp.).According to multivariate analysis, TG levels and SOFA scores were associated with mortality on days 0 and 1 (p = 0.018 and p = 0.008, resp.).

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.

ABSTRACT

Background: Despite extensive research and an improved standard of care, sepsis remains a disorder with a high mortality rate. Sepsis is accompanied by severe metabolic alterations.

Methods: We evaluated 117 patients with sepsis (severe sepsis [n = 19] and septic shock [n = 98]) who were admitted to the intensive care unit. Serum cholesterol, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), free fatty acid (FFA), and apolipoprotein (Apo) A-I levels were measured on days 0, 1, 3, and 7.

Results: Nonsurvivors had low levels of cholesterol, TG, HDL, LDL, and Apo A-I on days 0, 1, 3, and 7. In a linear mixed model analysis, the variations in TG, LDL, FFA, and Apo A-I levels over time differed significantly between the groups (p = 0.043, p = 0.020, p = 0.005, and p = 0.015, resp.). According to multivariate analysis, TG levels and SOFA scores were associated with mortality on days 0 and 1 (p = 0.018 and p = 0.008, resp.).

Conclusions: Our study illustrated that TG levels are associated with mortality in patients with sepsis. This may be attributable to alterations in serum lipid metabolism during sepsis, thus modulating the host response to inflammation in critically ill patients.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the inclusion and exclusion of patients in the study. A total of 179 patients were enrolled between August and December 2008, and 117 patients were included in the analysis. Patients who were being admitted for a second time (n = 4), those using steroids (n = 26), and those with a history of dyslipidemia (n = 13) or liver disease (n = 22) were excluded. Note: one patient had dyslipidemia and liver disease and two patients had liver disease and used steroids (≥15 mg/day) within the previous 7 days.
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fig1: Flow chart of the inclusion and exclusion of patients in the study. A total of 179 patients were enrolled between August and December 2008, and 117 patients were included in the analysis. Patients who were being admitted for a second time (n = 4), those using steroids (n = 26), and those with a history of dyslipidemia (n = 13) or liver disease (n = 22) were excluded. Note: one patient had dyslipidemia and liver disease and two patients had liver disease and used steroids (≥15 mg/day) within the previous 7 days.

Mentions: This was a prospective blood sampling and retrospective data analysis of a cohort of patients admitted to the medical ICU at a 2500-bed tertiary university medical center in Seoul, South Korea. The medical ICU is a 30-bed closed unit that is managed by certified ICU care specialists who only care for ICU patients. We enrolled patients admitted to the ICU with sepsis between August and December 2008; a total of 179 ICU patients were enrolled. Patients were excluded if they met specific criteria: age less than 18 years, pregnancy, ICU readmission, and a need for primary cardiac care. Patients with liver disease (hepatitis B, hepatitis C, immune hepatitis, liver cirrhosis, and hepatocellular carcinoma), dyslipidemia, or a history of statin or steroid (≥15 mg/day) use within the previous 7 days were also excluded from the study. Similarly, patients who had been treated with corticosteroid therapy for septic shock prior to admission to ICU were excluded. Finally, 117 patients were included for analysis in this study (Figure 1).


Prognostic Implications of Serum Lipid Metabolism over Time during Sepsis.

Lee SH, Park MS, Park BH, Jung WJ, Lee IS, Kim SY, Kim EY, Jung JY, Kang YA, Kim YS, Kim SK, Chang J, Chung KS - Biomed Res Int (2015)

Flow chart of the inclusion and exclusion of patients in the study. A total of 179 patients were enrolled between August and December 2008, and 117 patients were included in the analysis. Patients who were being admitted for a second time (n = 4), those using steroids (n = 26), and those with a history of dyslipidemia (n = 13) or liver disease (n = 22) were excluded. Note: one patient had dyslipidemia and liver disease and two patients had liver disease and used steroids (≥15 mg/day) within the previous 7 days.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4553311&req=5

fig1: Flow chart of the inclusion and exclusion of patients in the study. A total of 179 patients were enrolled between August and December 2008, and 117 patients were included in the analysis. Patients who were being admitted for a second time (n = 4), those using steroids (n = 26), and those with a history of dyslipidemia (n = 13) or liver disease (n = 22) were excluded. Note: one patient had dyslipidemia and liver disease and two patients had liver disease and used steroids (≥15 mg/day) within the previous 7 days.
Mentions: This was a prospective blood sampling and retrospective data analysis of a cohort of patients admitted to the medical ICU at a 2500-bed tertiary university medical center in Seoul, South Korea. The medical ICU is a 30-bed closed unit that is managed by certified ICU care specialists who only care for ICU patients. We enrolled patients admitted to the ICU with sepsis between August and December 2008; a total of 179 ICU patients were enrolled. Patients were excluded if they met specific criteria: age less than 18 years, pregnancy, ICU readmission, and a need for primary cardiac care. Patients with liver disease (hepatitis B, hepatitis C, immune hepatitis, liver cirrhosis, and hepatocellular carcinoma), dyslipidemia, or a history of statin or steroid (≥15 mg/day) use within the previous 7 days were also excluded from the study. Similarly, patients who had been treated with corticosteroid therapy for septic shock prior to admission to ICU were excluded. Finally, 117 patients were included for analysis in this study (Figure 1).

Bottom Line: Nonsurvivors had low levels of cholesterol, TG, HDL, LDL, and Apo A-I on days 0, 1, 3, and 7.In a linear mixed model analysis, the variations in TG, LDL, FFA, and Apo A-I levels over time differed significantly between the groups (p = 0.043, p = 0.020, p = 0.005, and p = 0.015, resp.).According to multivariate analysis, TG levels and SOFA scores were associated with mortality on days 0 and 1 (p = 0.018 and p = 0.008, resp.).

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.

ABSTRACT

Background: Despite extensive research and an improved standard of care, sepsis remains a disorder with a high mortality rate. Sepsis is accompanied by severe metabolic alterations.

Methods: We evaluated 117 patients with sepsis (severe sepsis [n = 19] and septic shock [n = 98]) who were admitted to the intensive care unit. Serum cholesterol, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), free fatty acid (FFA), and apolipoprotein (Apo) A-I levels were measured on days 0, 1, 3, and 7.

Results: Nonsurvivors had low levels of cholesterol, TG, HDL, LDL, and Apo A-I on days 0, 1, 3, and 7. In a linear mixed model analysis, the variations in TG, LDL, FFA, and Apo A-I levels over time differed significantly between the groups (p = 0.043, p = 0.020, p = 0.005, and p = 0.015, resp.). According to multivariate analysis, TG levels and SOFA scores were associated with mortality on days 0 and 1 (p = 0.018 and p = 0.008, resp.).

Conclusions: Our study illustrated that TG levels are associated with mortality in patients with sepsis. This may be attributable to alterations in serum lipid metabolism during sepsis, thus modulating the host response to inflammation in critically ill patients.

No MeSH data available.


Related in: MedlinePlus