title: Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis.
abstract: OBJECTIVE
  The purpose of the study is to evaluate the prevalence and clinical significance of hypolipidemia and the relationship to cytokine concentrations and outcomes in septic patients.
  
  
  METHODS
  A prospective study was undertaken including 50 patients with severe sepsis due to community-acquired infections. Serum concentrations of total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein as well as tumor necrosis factor α (TNF-α), interleukin (IL) 6, IL-8, IL-10, and transforming growth factor (TGF) β1 were determined on admission and days 3 and 10 during hospitalization.
  
  
  RESULTS
  Of the 50 patients enrolled, 28 survived, whereas 22 died during their hospital stay. Sepsis survivors had significantly higher HDL-C concentrations than nonsurvivors, whereas all patients with HDL-C values greater than 25 mg/dL survived. Baseline levels of TGF-β1 were significantly higher in survivors. High-density lipoprotein levels correlated inversely with TNF-α, IL-6, and IL-10 concentrations and positively with baseline TGF-β1 levels. Independent risk factors of mortality were IL-10 levels on day 3, whereas HDL-C concentration on admission was related to survival.
  
  
  CONCLUSIONS
  Low cholesterol and lipoprotein concentrations are detected in septic patients, especially in individuals with poor outcome. High-density lipoprotein cholesterol concentration seems to be an early independent predictive marker of survival in severe sepsis.
authors.affiliation: Section of Infectious Diseases, Patras University Hospital, 26442 Patras, Greece. Electronic address: alekkou@yahoo.gr.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lekkou
authors.affiliation: Division of Hematology, Department of Internal Medicine, Patras University Hospital, School of Medicine, 26504 Patras, Greece.
authors.forename: Athanassia
authors.initials: A
authors.lastname: Mouzaki
authors.affiliation: Department of Internal Medicine, Patras University Hospital, 26504 Patras, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Siagris
authors.affiliation: Intensive Care Unit, Agios Andreas Hospital, 26335 Patras, Greece.
authors.forename: Ifigenia
authors.initials: I
authors.lastname: Ravani
authors.affiliation: Section of Infectious Diseases, Patras University Hospital, School of Medicine, 26504 Patras, Greece.
authors.forename: Charalambos A
authors.initials: CA
authors.lastname: Gogos
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood; D017714:Community-Acquired Infections / Q000150:complications; D016207:Cytokines / Q000097:blood; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D016212:Transforming Growth Factor beta / Q000097:blood; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D008055:Lipids; D008075:Lipoproteins, HDL; D016212:Transforming Growth Factor beta; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D002784:Cholesterol
keywords: Cytokines; High-density lipoprotein; Lipoproteins; Sepsis; Transforming growth factor (TGF) β(1)