title: Serum lipids act as inverse acute phase reactants and are falsely low in patients with critical limb ischemia.
abstract: BACKGROUND
  Lipid levels generally fall after an acute myocardial infarction. This study was conducted to see what trends lipid levels had in patients who underwent operation for critical limb ischemia.
  
  
  METHODS
  The study was prospective and included 30 patients who underwent operation for critical limb ischemia. Serum lipid profiles and C-reactive protein were analyzed before surgery and 3 months after peripheral bypass surgery. In addition, comparison of lipid levels after surgery was made with 287 healthy and 283 ischemic heart disease controls from The Copenhagen City Heart Study.
  
  
  RESULTS
  Total, low density lipoprotein, and high density lipoprotein cholesterol levels were found to be significantly lower before surgery than 3 months after surgery (P <.001). In contrast, C-reactive protein was higher before surgery and decreased after 3 months (P <.0001). An inverse linear correlation was found between total cholesterol/low density lipoprotein cholesterol and C-reactive protein (P <.001 and P <.04, respectively). Comparison with controls showed that cholesterol levels 3 months after surgery were significantly lower (P <.009).
  
  
  CONCLUSIONS
  Serum cholesterol levels are not reliable in the preoperative period and should therefore be measured at least 3 months after surgery when they seem to approach a more representative level.
authors.affiliation: Department of Vascular Surgery, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Jean
authors.initials: J
authors.lastname: Bismuth
authors.forename: Steen Christian
authors.initials: SC
authors.lastname: Kofoed
authors.forename: Annette Schophuus
authors.initials: AS
authors.lastname: Jensen
authors.forename: Amar
authors.initials: A
authors.lastname: Sethi
authors.forename: Henrik
authors.initials: H
authors.lastname: Sillesen
mesh_terms: D000209:Acute-Phase Proteins; D000368:Aged; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008055:Lipids / Q000097:blood*; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood; D011446:Prospective Studies
chemical_list: D000209:Acute-Phase Proteins; D008055:Lipids; D002784:Cholesterol