Lipoproteins and CETP levels as risk factors for severe sepsis in hospitalized patients
Article first published online: 17 MAR 2010
© 2010 The Authors. Journal Compilation © 2010 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 40, Issue 4, pages 330–338, April 2010
How to Cite
Grion, C. M. C., Cardoso, L. T. Q., Perazolo, T. F., Garcia, A. S., Barbosa, D. S., Morimoto, H. K., Matsuo, T. and Carrilho, A. J. F. (2010), Lipoproteins and CETP levels as risk factors for severe sepsis in hospitalized patients. European Journal of Clinical Investigation, 40: 330–338. doi: 10.1111/j.1365-2362.2010.02269.x
- Issue published online: 17 MAR 2010
- Article first published online: 17 MAR 2010
- Received 26 August 2009; accepted 1 February 2010
- Cholesterol ester transfer protein;
- risk factor;
Eur J Clin Invest 2010; 40 (4): 330–338
Background The magnitude of lipoprotein level reduction during the acute-phase response may be associated with the severity and mortality of sepsis. However, it remains to be determined whether low lipoprotein levels can be considered a risk factor for developing sepsis. We aimed to investigate lipoprotein levels as risk factors for sepsis in hospitalized patients, and also describe sequential changes in lipoprotein and cholesterol ester transfer protein (CETP) levels during sepsis.
Design This is a prospective cohort study and case–control analysis from selected hospitalized patients. Blood samples were collected at admission, and participants were monitored for severe sepsis. Total cholesterol, high density lipoprotein (HDL), low density lipoprotein, and triglyceride levels were compared between sepsis cases and controls. Cholesterol, apolipoprotein, phospholipid and CETP concentrations were monitored in the case group.
Results Of 1719 enrolled patients, 51 developed severe sepsis and were paired with 71 controls by age, gender, presence of infection at admission and chronic disease. HDL cholesterol level at admission was a risk factor for severe sepsis (OR = 0·969; 95% CI: 0·944–0·995). Mean CETP levels diminished between hospital admission and day 3 of sepsis. The magnitude of this variation (ΔCETP) was more pronounced in non-survivors (0·78 ± 1·08 μg mL−1) than that in survivors (0·02 ± 0·58 μg mL−1, P = 0·01).
Conclusions HDL cholesterol may have a protective effect against sepsis. Each 1 mg dL−1 increase in HDL decreased the odds of severe sepsis by 3% during hospitalization. The reduction of plasma CETP was associated with mortality.