title: Hypertriglyceridemia: a possible diagnostic marker of disease severity in visceral leishmaniasis.
abstract: OBJECTIVE
  Visceral leishmaniasis (VL), a protozoan disease, is 100% fatal if left untreated. Anemia is common in VL which plays a role in expression of clinically overt VL disease. Laboratory clues are scarce for strengthening clinical suspicion for severity in VL. Hypertriglyceridemia has emerged as a new concept for the diagnosis and prognosis in VL. The present study is aimed at correlating the magnitude of hypertriglyceridemia with the severity in VL.
  
  
  METHODS
  A retrospective case-control study was conducted between January 2012 to December 2013 among 124 patients coming for treatment from VL endemic areas, who had fever of more than 15 days and did not respond to antimalarials and antibiotics. The parasitologically confirmed VL cases (n = 87) were categorized as mild/moderate (n = 60) and severe (n = 27) groups according to WHO classification for anemia and parasite burden. Serum triglycerides were assayed in VL groups along with controls (n = 37).
  
  
  RESULTS
  Serum triglyceride level was significantly higher in VL than controls [mean values were 173.50 ± 47.67 versus 127.1 ± 53.79 mg/dl, respectively (p < 0.0001)]. Triglyceride level was significantly higher in severe than in mild/moderate group of VL [211.3 ± 50.2 mg/dl versus 134 ± 45.09 mg/dl, respectively (p < 0.0001)]. Hypertriglyceridemia (>161.7 mg/dl) was noted in all severe VL patients, compared to 31.66% of mild or moderate group (p < 0.0001). There was no significant difference between mild/moderate VL and controls.
  
  
  CONCLUSIONS
  It is hypothesized that hypertriglyceridemia could be of additional diagnostic benefit to assess the probability and severity of VL in endemic areas.
authors.affiliation: Division of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India. drcslal@gmail.com.
authors.forename: C S
authors.initials: CS
authors.lastname: Lal
authors.affiliation: Division of Social Sciences, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India. rbihariverma@yahoo.com.
authors.forename: R B
authors.initials: RB
authors.lastname: Verma
authors.affiliation: Division of Pathology, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: N
authors.initials: N
authors.lastname: Verma
authors.affiliation: Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: N A
authors.initials: NA
authors.lastname: Siddiqui
authors.affiliation: Division of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: V N
authors.initials: VN
authors.lastname: Rabidas
authors.affiliation: Division of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: K
authors.initials: K
authors.lastname: Pandey
authors.affiliation: Division of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: D
authors.initials: D
authors.lastname: Singh
authors.affiliation: Division of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: S
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Division of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Paswan
authors.affiliation: Division of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: A
authors.initials: A
authors.lastname: Kumari
authors.affiliation: Division of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: P
authors.initials: P
authors.lastname: Sinha
authors.affiliation: Division of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India.
authors.forename: P
authors.initials: P
authors.lastname: Das
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000175:diagnosis* / Q000209:etiology*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D059208:Parasite Load; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Anemia; Severity; Triglyceride; Visceral leishmaniasis