Comparison of Lipid Profile in Septic and Non-Septic Patients

Background: The nature of changes in the lipid profile caused by an acute infection is controversial. Objective: In this study we compared concentrations of plasma lipids in 70 septic and non-septic patients in ICU and studied the prognostic impact of cholesterol, LDL-C, HDL-C and triglyceride. Methods: From March 2009 to February 2010, all patients consecutively admitted to the Intensive Care Units of Rasoul Akram University Hospital, Tehran, Iran, were studied. Each person was examined for signs and symptoms of infection during hospital stay. Patients were classified as suffering from sepsis or not at the first 24 hours of admission. Descriptive results of continuous variables were expressed as mean (±SD). The associations between factors were analyzed by t-test and between factors and prognosis by ?2 test when appropriate. Results: The study population included 28 males and 42 females with mean (± standard deviation) age of years 73.6 ± 15.7 that 29 of them were in sepsis group and 41 of them in non-sepsis group. There wasn’t any relationship between sex and mortality (p= 0.34), although by increasing age mortality leveled out (r=-0.58, p= 0.04).The concentrations of total cholesterol (89.3 ± 33.6 vs 100.7 ± 25.3 mg/dl), HDL (20 ± 5.6 vs 30.2 ±8.7 mg/dl), and LDL (61.5 ± 18.7 vs 70.6 ± 14.5 mg/dl) showed significantly lower values in septic group but no difference could be find in triglyceride level (177.7 ± 28.7 vs 182.8± 45.9 mg/dl). In septic group the initial and second levels of cholesterol were considerably higher in patients who died than those who survived (101.6 ± 37.5 versus 69.4 ± 8.3 and 103.2 ± 23.4 versus 79.4 ± 47 respectively, p=0.00). Conclusion: In ICU setting, measurement of cholesterol values has been shown to improve risk prediction, and inclusion of lipid values in clinical risk assessment scores of critically ill patients has been advocated. Further understanding of the alterations in lipid metabolism may have therapeutic implications in treatment of sepsis.