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01-11-2009 | Original

Changes in HDL-associated apolipoproteins relate to mortality in human sepsis and correlate to monocyte and platelet activation

Authors: Stefan Barlage, Carsten Gnewuch, Gerhard Liebisch, Zsuzsanna Wolf, Franz-Xaver Audebert, Thomas Glück, Dieter Fröhlich, Bernhard K. Krämer, Gregor Rothe, Gerd Schmitz

Published in: Intensive Care Medicine | Issue 11/2009

Abstract

Objective

Lipoproteins modulate vascular cell function in inflammation. In this study, we analyzed whether plasma concentrations of lipoproteins and apolipoproteins in human sepsis are related to patient survival and the activation of blood monocytes and platelets.

Design

Observational study.

Setting

Medical and surgical intensive care units (ICU) of a university hospital.

Patients

151 consecutive patients after sepsis criteria had been met for the first time.

Interventions

None.

Measurements

Plasma lipoproteins, apolipoproteins, platelet CD62P-expression, monocyte HLA-DR-expression, SAPS II-scores (Simplified Acute Physiology Score) and 30-day-mortality were recorded.

Results

Total cholesterol, high-density-lipoprotein (HDL) and low-density-lipoprotein (LDL) cholesterol, apolipoprotein (apo)-AI and apo-B were all found to be significantly lower in non-survivors than in survivors. In contrast to other (apo)lipoproteins, apo-AI and HDL cholesterol further decreased in non-survivors during the ICU stay. Logistic regression analysis revealed apo-AI to be an independent predictor of 30-day-mortality. A significant inverse correlation was found for apo-AI/HDL-cholesterol and platelet activation. Later in the course of the disease, HLA-DR expression on monocytes correlated positively to apo-AI and apo-CI concentrations and inversely to the apo-E concentration.

Conclusion

Low apo-AI is independently related to 30-day mortality in human sepsis and the decrease in apo-AI/HDL cholesterol correlates to increased platelet activation. Moreover, changes in apolipoproteins supposed to modulate lipopolysaccharide effects, such as apo-CI and apo-E, correlate to monocyte activation.

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Title: Changes in HDL-associated apolipoproteins relate to mortality in human sepsis and correlate to monocyte and platelet activation
Authors: Stefan Barlage
Carsten Gnewuch
Gerhard Liebisch
Zsuzsanna Wolf
Franz-Xaver Audebert
Thomas Glück
Dieter Fröhlich
Bernhard K. Krämer
Gregor Rothe
Gerd Schmitz
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 11/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1609-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in HDL-associated apolipoproteins relate to mortality in human sepsis and correlate to monocyte and platelet activation

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements

Results

Conclusion

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