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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

Receiver operator characteristic (ROC) curves of triglyceride levels and Sequential Organ Failure Assessment (SOFA) scores to predict mortality. On the day of admission, the area under curve for triglyceride levels was 0.62 (sensitivity = 94.7%, specificity = 29.6, and p = 0.066), and that for the SOFA score was 0.63 (sensitivity = 21.2%, specificity = 96.9, and p = 0.019). In addition, adjusting for triglyceride levels with the SOFA score significantly improved the predictive accuracy of 28-day mortality (AUC = 0.716, sensitivity = 71.1%, specificity = 66.7%, and p < 0.001).
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fig3: Receiver operator characteristic (ROC) curves of triglyceride levels and Sequential Organ Failure Assessment (SOFA) scores to predict mortality. On the day of admission, the area under curve for triglyceride levels was 0.62 (sensitivity = 94.7%, specificity = 29.6, and p = 0.066), and that for the SOFA score was 0.63 (sensitivity = 21.2%, specificity = 96.9, and p = 0.019). In addition, adjusting for triglyceride levels with the SOFA score significantly improved the predictive accuracy of 28-day mortality (AUC = 0.716, sensitivity = 71.1%, specificity = 66.7%, and p < 0.001).

Mentions: The correlation between serum lipid levels and SOFA scores is shown in Table 3. Overall, the level of each lipid correlated well with the SOFA score, excluding TG and FFA. TG levels were not correlated with SOFA scores for the 7 days of ICU stay. The continuous TG level/SOFA score curve is shown in Figure 3, and it was a more accurate predictor of the 28-day mortality rate in ICU patients with sepsis than the SOFA score alone (area under the curve [AUC] = 0.717, p < 0.001 and AUC = 0.634, p = 0.029, resp.).


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)

Receiver operator characteristic (ROC) curves of triglyceride levels and Sequential Organ Failure Assessment (SOFA) scores to predict mortality. On the day of admission, the area under curve for triglyceride levels was 0.62 (sensitivity = 94.7%, specificity = 29.6, and p = 0.066), and that for the SOFA score was 0.63 (sensitivity = 21.2%, specificity = 96.9, and p = 0.019). In addition, adjusting for triglyceride levels with the SOFA score significantly improved the predictive accuracy of 28-day mortality (AUC = 0.716, sensitivity = 71.1%, specificity = 66.7%, and p < 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Receiver operator characteristic (ROC) curves of triglyceride levels and Sequential Organ Failure Assessment (SOFA) scores to predict mortality. On the day of admission, the area under curve for triglyceride levels was 0.62 (sensitivity = 94.7%, specificity = 29.6, and p = 0.066), and that for the SOFA score was 0.63 (sensitivity = 21.2%, specificity = 96.9, and p = 0.019). In addition, adjusting for triglyceride levels with the SOFA score significantly improved the predictive accuracy of 28-day mortality (AUC = 0.716, sensitivity = 71.1%, specificity = 66.7%, and p < 0.001).
Mentions: The correlation between serum lipid levels and SOFA scores is shown in Table 3. Overall, the level of each lipid correlated well with the SOFA score, excluding TG and FFA. TG levels were not correlated with SOFA scores for the 7 days of ICU stay. The continuous TG level/SOFA score curve is shown in Figure 3, and it was a more accurate predictor of the 28-day mortality rate in ICU patients with sepsis than the SOFA score alone (area under the curve [AUC] = 0.717, p < 0.001 and AUC = 0.634, p = 0.029, resp.).

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