title: Cholesterol--a marker of nutritional status in mild to moderate heart failure.
abstract: OBJECTIVE
  To assess the association between serum cholesterol and nutritional status in patients with stable mild to moderate chronic heart failure (CHF).
  
  
  BACKGROUND
  Hypercholesterolemia is a well-established risk factor for mortality and morbidity in coronary heart disease. In an apparent paradox, lower serum cholesterol has been associated with worse prognosis in CHF. Pre-albumin is the preferred marker for undernutrition in chronic diseases.
  
  
  METHODS
  We evaluated 92 CHF patients, mean age 68 years, mean body mass index 27 kg/m(2); 44 with ischemic etiology; 41 in New York Heart Association class I. Patients were included after a period of at least 2 months of clinical stability. Spearman's correlation coefficient between serum cholesterol and pre-albumin, both in the whole sample and stratifying by the use of statins was calculated.
  
  
  RESULTS
  Median (interquartile range) cholesterol level was 174 (142-214) mg/dl and median pre-albumin level was 31 (25-37) mg/dl. Overall, there was a moderately strong and statistically significant positive correlation between pre-albumin and serum cholesterol (Rho=0.57, p<0.001). Among the 20 patients not on statin the correlation coefficient was 0.84 (p<0.001), while among the 72 patients under a statin the correlation was 0.49 (p<0.001).
  
  
  CONCLUSIONS
  Our results suggest that in stable mild to moderate CHF patients, cholesterol levels are closely related with nutritional status irrespective of therapy with a statin.
authors.affiliation: Serviço de Medicina Interna - Hospital S. João, Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto, Portugal. pauloaraujo@netc.pt
authors.forename: José Paulo
authors.initials: JP
authors.lastname: Araújo
authors.forename: Fernando
authors.initials: F
authors.lastname: Friões
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
authors.forename: Patrícia
authors.initials: P
authors.lastname: Lourenço
authors.forename: Francisco
authors.initials: F
authors.lastname: Rocha-Gonçalves
authors.forename: António
authors.initials: A
authors.lastname: Ferreira
authors.forename: Paulo
authors.initials: P
authors.lastname: Bettencourt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects / Q000502:physiology*; D011228:Prealbumin / Q000378:metabolism
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011228:Prealbumin; D002784:Cholesterol