Low HDL levels in sepsis versus trauma patients in intensive care unit
Abstract Background The protective cardiovascular effect of high-density lipoproteins (HDLs) is considered to chiefly rely on reverse cholesterol transport from peripheral tissues back to the liver. However, HDL particles display pleiotropic properties, including anti-inflammatory, anti-apoptotic or...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-06-01
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| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13613-017-0284-3 |
| _version_ | 1818684905657204736 |
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| author | Sébastien Tanaka Julien Labreuche Elodie Drumez Anatole Harrois Sophie Hamada Bernard Vigué David Couret Jacques Duranteau Olivier Meilhac |
| author_facet | Sébastien Tanaka Julien Labreuche Elodie Drumez Anatole Harrois Sophie Hamada Bernard Vigué David Couret Jacques Duranteau Olivier Meilhac |
| author_sort | Sébastien Tanaka |
| collection | DOAJ |
| description | Abstract Background The protective cardiovascular effect of high-density lipoproteins (HDLs) is considered to chiefly rely on reverse cholesterol transport from peripheral tissues back to the liver. However, HDL particles display pleiotropic properties, including anti-inflammatory, anti-apoptotic or antioxidant functions. Some studies suggest that HDL concentration decreases during sepsis, and an association was reported between low HDL levels and a poor outcome. Like sepsis, trauma is also associated with a systemic inflammatory response syndrome. However, no study has yet explored changes in lipid profiles during trauma. We sought to compare lipid profiles between sepsis and trauma patients in intensive care unit (ICU). In septic patients, we analyzed the association between lipid profile, severity and prognosis. Methods A prospective, observational, single-centered study was conducted in a surgical ICU. For each patient, total cholesterol, HDL, triglyceride and low-density lipoprotein cholesterol levels were assessed at admission. Short-term prognosis outcome was prospectively assessed. Results Seventy-five consecutive patients were admitted (50 sepsis and 25 trauma). There was no difference in SOFA and SAPSII scores between the two groups. Patients with sepsis had lower total cholesterol levels than patients with trauma. Regarding the lipoprotein profile, only HDLs differed significantly between the two groups (median [IQR] = 0.33 mmol/l [0.17–0.78] in sepsis patients versus median [IQR] = 0.99 mmol/l [0.74–1.28] in trauma patients; P < 0.0001). Whereas ICU mortality was not associated with lipid levels in the sepsis group, a significant negative correlation was found between HDL concentration and the length of ICU stay (r = −0.35; P = 0.03) in the group of survivor septic patients at ICU discharge. In addition, poor outcome defined as death or a SOFA score >6 at day 3 was associated with lower HDL levels (median [IQR] = 0.20 mmol/l [0.11–0.41] vs. 0.35 mmol/l [0.19–0.86] in patients with poor outcome versus others; P = 0.03). Conclusions Lipid profile was totally different between sepsis and trauma in ICU patients: HDL levels were low in septic patients, whereas their concentration was not altered in trauma patients. This major difference reinforces the necessity to explore the therapeutic potential of HDL in sepsis. |
| first_indexed | 2024-12-17T10:58:04Z |
| format | Article |
| id | doaj.art-df3f435e3d534fd18ac15197eb7e931a |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-17T10:58:04Z |
| publishDate | 2017-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-df3f435e3d534fd18ac15197eb7e931a2022-12-21T21:51:46ZengSpringerOpenAnnals of Intensive Care2110-58202017-06-01711810.1186/s13613-017-0284-3Low HDL levels in sepsis versus trauma patients in intensive care unitSébastien Tanaka0Julien Labreuche1Elodie Drumez2Anatole Harrois3Sophie Hamada4Bernard Vigué5David Couret6Jacques Duranteau7Olivier Meilhac8Assistance Publique des Hopitaux de Paris, Service d’Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-SudDépartement de biostatistique, Université de Lille, CHU LilleDépartement de biostatistique, Université de Lille, CHU LilleAssistance Publique des Hopitaux de Paris, Service d’Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-SudAssistance Publique des Hopitaux de Paris, Service d’Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-SudAssistance Publique des Hopitaux de Paris, Service d’Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-SudUniversité de La Réunion, INSERM, UMR 1188 Diabète athérothombose Réunion Océan Indien (DéTROI)Assistance Publique des Hopitaux de Paris, Service d’Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-SudUniversité de La Réunion, INSERM, UMR 1188 Diabète athérothombose Réunion Océan Indien (DéTROI)Abstract Background The protective cardiovascular effect of high-density lipoproteins (HDLs) is considered to chiefly rely on reverse cholesterol transport from peripheral tissues back to the liver. However, HDL particles display pleiotropic properties, including anti-inflammatory, anti-apoptotic or antioxidant functions. Some studies suggest that HDL concentration decreases during sepsis, and an association was reported between low HDL levels and a poor outcome. Like sepsis, trauma is also associated with a systemic inflammatory response syndrome. However, no study has yet explored changes in lipid profiles during trauma. We sought to compare lipid profiles between sepsis and trauma patients in intensive care unit (ICU). In septic patients, we analyzed the association between lipid profile, severity and prognosis. Methods A prospective, observational, single-centered study was conducted in a surgical ICU. For each patient, total cholesterol, HDL, triglyceride and low-density lipoprotein cholesterol levels were assessed at admission. Short-term prognosis outcome was prospectively assessed. Results Seventy-five consecutive patients were admitted (50 sepsis and 25 trauma). There was no difference in SOFA and SAPSII scores between the two groups. Patients with sepsis had lower total cholesterol levels than patients with trauma. Regarding the lipoprotein profile, only HDLs differed significantly between the two groups (median [IQR] = 0.33 mmol/l [0.17–0.78] in sepsis patients versus median [IQR] = 0.99 mmol/l [0.74–1.28] in trauma patients; P < 0.0001). Whereas ICU mortality was not associated with lipid levels in the sepsis group, a significant negative correlation was found between HDL concentration and the length of ICU stay (r = −0.35; P = 0.03) in the group of survivor septic patients at ICU discharge. In addition, poor outcome defined as death or a SOFA score >6 at day 3 was associated with lower HDL levels (median [IQR] = 0.20 mmol/l [0.11–0.41] vs. 0.35 mmol/l [0.19–0.86] in patients with poor outcome versus others; P = 0.03). Conclusions Lipid profile was totally different between sepsis and trauma in ICU patients: HDL levels were low in septic patients, whereas their concentration was not altered in trauma patients. This major difference reinforces the necessity to explore the therapeutic potential of HDL in sepsis.http://link.springer.com/article/10.1186/s13613-017-0284-3SepsisTraumaLipidsInflammationHigh-density lipoproteinsICU |
| spellingShingle | Sébastien Tanaka Julien Labreuche Elodie Drumez Anatole Harrois Sophie Hamada Bernard Vigué David Couret Jacques Duranteau Olivier Meilhac Low HDL levels in sepsis versus trauma patients in intensive care unit Annals of Intensive Care Sepsis Trauma Lipids Inflammation High-density lipoproteins ICU |
| title | Low HDL levels in sepsis versus trauma patients in intensive care unit |
| title_full | Low HDL levels in sepsis versus trauma patients in intensive care unit |
| title_fullStr | Low HDL levels in sepsis versus trauma patients in intensive care unit |
| title_full_unstemmed | Low HDL levels in sepsis versus trauma patients in intensive care unit |
| title_short | Low HDL levels in sepsis versus trauma patients in intensive care unit |
| title_sort | low hdl levels in sepsis versus trauma patients in intensive care unit |
| topic | Sepsis Trauma Lipids Inflammation High-density lipoproteins ICU |
| url | http://link.springer.com/article/10.1186/s13613-017-0284-3 |
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