Abstract
BACKGROUND: Reduced cholesterol levels are associated with increased organ failure and mortality in sepsis. Cholesterol levels may vary by infection type (gram negative vs positive), possibly reflecting differences in cholesterol-mediated bacterial clearance.
METHODS: This was a secondary analysis of a combined data set of 2 prospective cohort studies of adult patients meeting Sepsis-3 criteria. Infection types were classified as gram negative, gram positive, or culture negative. We investigated quantitative (levels) and qualitative (dysfunctional high-density lipoprotein [HDL]) cholesterol differences. We used multivariable logistic regression to control for disease severity.
RESULTS: Among 171 patients with sepsis, infections were gram negative in 67, gram positive in 46, and culture negative in 47. Both gram-negative and gram-positive infections occurred in 11 patients. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and HDL cholesterol (HDL-C) levels were lower for culture-positive sepsis at enrollment (TC, P < .001; LDL-C, P < .001; HDL-C, P = .011) and persisted after controlling for disease severity. Similarly, cholesterol levels were lower among culture-positive patients at 48 hours (TC, P = .012; LDL-C, P = .029; HDL-C, P = .002). Triglyceride (TG) levels were lower at enrollment ( P =.033) but not at 48 hours ( P = .212). There were no differences in dysfunctional HDL. Among bacteremic patients, cholesterol levels were lower at enrollment (TC, P = .010; LDL-C, P = .010; HDL-C, P ≤ .001; TG, P = .005) and at 48 hours (LDL-C, P = .027; HDL-C, P < .001; TG, P = .020), except for 48 hour TC ( P = .051). In the bacteremia subgroup, enrollment TC and LDL-C were lower for gram-negative versus gram-positive infections (TC, P = .039; LDL-C, P = .023).
CONCLUSION: Cholesterol levels are significantly lower among patients with culture-positive sepsis and bacteremia.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 808-817 |
| Number of pages | 10 |
| Journal | Journal of Intensive Care Medicine |
| Volume | 36 |
| Issue number | 7 |
| Early online date | Jun 24 2020 |
| DOIs | |
| State | Published - Jul 2021 |
Bibliographical note
Funding Information:The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The parent studies were supported by an NIGMS K23 (1K23GM115690-01A1 [Faheem W. Guirgis]) and a Society of Critical Care Medicine Vision Grant (Faheem W. Guirgis). The authors disclose the following salary support: NCATS 1KL2TROO1429 (Lauren Page Black); Minneapolis Medical Research Foundation (Michael A. Puskarich); Department of Defense W81XWH1810089; W81XWH-15-1-0403 (Rosemarie Fernandez); NIGMS 1K23GM115690-01A1 (Faheem W. Guirgis).
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The parent studies were supported by an NIGMS K23 (1K23GM115690-01A1 [Faheem W. Guirgis]) and a Society of Critical Care Medicine Vision Grant (Faheem W. Guirgis). The authors disclose the following salary support: NCATS 1KL2TROO1429 (Lauren Page Black); Minneapolis Medical Research Foundation (Michael A. Puskarich); Department of Defense W81XWH1810089; W81XWH-15-1-0403 (Rosemarie Fernandez); NIGMS 1K23GM115690-01A1 (Faheem W. Guirgis).
Publisher Copyright:
© The Author(s) 2020.
Keywords
- culture positive
- gram negative
- gram positive
- lipids
- organ failure
- Prospective Studies
- Humans
- Triglycerides
- Bacteremia
- Cholesterol
- Shock, Septic
- Adult
- Sepsis
PubMed: MeSH publication types
- Journal Article