Regulatory role of HDL on systemic inflammatory response in adult bacterial sepsis
Journal Title: Medpulse International Journal of Biochemistry - Year 2018, Vol 7, Issue 3
Abstract
Background: Inspite of the recent advances available in the intensive care units (ICU) there is still an increasing incidence of sepsis and sepsis related deaths. Recent studies suggest that high density lipoprotein (HDL) neutralizes and helps in clearance of lipopolysaccharide (LPS) or lipoteichoic acid (LTA) from circulation by the liver. Aims and Objectives: To conduct a prospective case control study to determine whether circulating HDL is a critical predictor of risk and severity of bacterial sepsis. Materials and Methods: During the study period 234 adult patients were clinically diagnosed to have sepsis. Out of these 35 patients were reported to have positive blood culture (confirmed sepsis group or Group 1). Thirty five age and sex matched patients were randomly selected from the suspected sepsis patients as Group 2. Thirty five normal healthy age and sex matched adults were taken as Group 3 (controls). Venous blood samples were collected from all these patients before the administration of antibiotics. The collected blood sample was used for complete blood count, HDL and CRP estimations. The gold standard for the diagnosis of sepsis was positive blood culture. Results and Observation: The CRP levels were significantly increased and HDL levels were significantly low in confirmed sepsis (p<0.0001) and suspected sepsis (p<0.0001) when compared to that of control subjects. HDL levels <32.25mg/dl showed 91.18% sensitivity and 75.0% specificity to differentiate between confirmed sepsis and healthy subjects. There was a significant negative correlation between HDL and CRP. The overall correlation coefficient r is - 0.54 and P value is <0.0001. Conclusion: From this study, it is clear that HDL levels are significantly decreased in response to bacterial infection or inflammation. The decrease in HDL is well correlated with increased levels of CRP. HDL levels in bacterial sepsis may have a value in identifying patients with infection.
Authors and Affiliations
Naga Mrudula M, Lingraj Patil
Keywords
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