Lipoprotein metabolism in patients with severe sepsis

Abstract

In patients with severe sepsis, lipoprotein concentrations rapidly change and can be reduced to 50% of recovery concentrations. The pattern of early rapid decline is found primarily in the HDL and a slow recovery in both HDL and LDL fractions. The correlation between apolipoprotein and lipoprotein cholesterol concentrations suggests a decline in lipoprotein particles. During severe sepsis, HDL is shifted to acute phase HDL, which is enriched in serum amyloid A and depleted of cholesterol and apolipoprotein A-1. Lipoprotein concentrations are unable to discriminate between survivors and nonsurvivors.

Association Between Age, Body Mass Index, Waist Circumference, Lipid Profile Parameters, and Symptomatic Bacterial Urinary Tract Infection in Iraqi Adult Women

“…The results obtained by Johnkennedy et al [5] agreed with our results concerning that patients with urinary tract infections had significantly decreased levels of TC, TG, high-density lipoprotein, and low-density lipoprotein. VanLeeuwen et al [34] exhibited results went with our findings as they showed a significant decrease in the serum levels of TC, TG, high-density lipoprotein, and low-density lipoprotein for patients with acute illness when compared with control group. Alvarez and Romas [35] mentioned that serum levels of high-density lipoprotein were significantly (p<0.05) decreased during sepsis.…”

Low-density lipoprotein protects Vibrio vulnificus-induced lethality through blocking lipopolysaccharide action

“…Total cholesterol, HDL, and LDL are reduced in serum of patients with sepsis and in contrast, plasma triglyceride is elevated (Fraunberger et al, 1999;Pussinen et al, 2001;Kitchens et al, 2003;van Leeuwen et al, 2003;Khovidhunkit et al, 2004). In this study, we observed that levels of total cholesterol, triglyceride and LDL is reduced but level of HDL is relatively unchanged in patient with V. vulnificus sepsis, which shows a different serum profile of lipid from other sepsis.…”

HDL in Infectious Diseases and Sepsis

“…In summary, all the observations showing that the increase of HDL is associated with an attenuation of LPS-induced inflammatory response (Levine et al 1993;van Leeuwen et al 2003) strongly favor the hypothesis that raising plasma HDL may represent a therapeutic approach in the treatment of sepsis and its complications. The picture however is more complicated, and not only HDL quantity but also HDL quality/composition is critical.…”

“…In patients with severe sepsis, HDL-C decreases rapidly, and SAA is the major protein present in HDL (45 %) at the start of sepsis and is slowly replaced by apoA-I during recovery (van Leeuwen et al 2003). Low HDL-C levels inversely correlate with the severity of septic disease and associate with an exaggerated systemic inflammatory response (Wendel et al 2007), although it is difficult to establish whether changes in plasma lipoproteins simply reflect the severity of disease or they can directly modify the host response to inflammation.…”