Low HDL levels and the risk of death, sepsis and malignancy.
BACKGROUND
High density lipoprotein (HDL) plays an important role as an anti-atherogenic molecule, but also possesses anti-inflammatory and anti-angiogenic properties. The effect of extremely low levels of HDL on the risk of sepsis and malignancy were therefore examined.


METHODS
A retrospective analysis of patients hospitalized at the Edith Wolfson Medical center was conducted. Patients were divided into Group 1: 108 patients with serum HDL levels < or =20 mg/dl. Group 2: 96 patients with serum HDL levels > or =65 mg/dl. Medical history and laboratory data was recorded.


RESULTS
The mean HDL levels in Group 1 were 16.1 +/- 33 mg/dl compared to 74.9 +/- 12.6 mg/dl in Group 2. Using a multivariate logistic regression analysis, low HDL was inversely associated with death (OR 0.96, 95% 0.93-0.99, P = 0.02), 3.98 fold increase in odds of fever (OR 3.98, 95% CI 1.3-11.8, P = 0.01), and 6.7-fold increase in the risk of cancer (OR 6.68, 95% CI 1.8-24.5, P = 0.004). HDL serum levels were inversely associated with sepsis. For each 1 mg/dl increase in HDL, a relative 11% decrease in odds of sepsis was observed (OR 0.886, 95% CI 0.8-0.976, P = 0.01).


CONCLUSIONS
Extremely low serum HDL levels (< or =20 mg/dl) are associated with an increased risk of death, sepsis and malignancy.
Dept. of Internal Medicine, The Edith Wolfson Medical Centre, Sackler School of Medicine, Tel Aviv University, Holon, Israel.
Renana
R
Shor
Julio
J
Wainstein
David
D
Oz
Mona
M
Boaz
Zipora
Z
Matas
Asora
A
Fux
Aaron
A
Halabe
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000378:metabolism; D006801:Humans; D007009:Hypolipoproteinemias / Q000175:diagnosis* / Q000453:epidemiology* / Q000378:metabolism; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000378:metabolism; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018805:Sepsis / Q000453:epidemiology* / Q000378:metabolism; D015996:Survival Rate
D008075:Lipoproteins, HDL