Introduction Lipoproteins were shown to neutralize LPS and to exert direct anti-inflammatory actions. Neutrophil CD64-expression (nCD64) was shown to be an early inflammatory sign.
Objectives To examine whether plasma concentrations of high (HDL)- or low (LDL)-density lipoproteins are related to nCD64, triglycerides, glucose, severity of illness (PRISM, PELOD), length of stay (LOS) or mechanical ventilation (LOMV), and mortality in children with sepsis (S) and severe sepsis/septic shock (SS) compared to those with trauma (T) or healthy controls (C).
Methods 48 children were classified into 4 groups of SS, S, T, and C (12 each). Blood samples were collected on 3 consecutive days following admission.
Results On day 1 HDL, LDL, and cholesterol were found to be significantly lower in SS and S compared to C (29.5±2.7 and 27.3±4.2, vs. 58.8±5.8 mg/dl, p<0.001, 33.4±5.8 and 66.2±9, vs. 98.1±6.5 mg/dl, p<0.001, 100.6±9 and 125.2±16, vs. 171.3±7 mg/dl, p<0.001 respectively). Opposite trends followed triglycerides (209±61 and 151.7±25, vs. 71.8±10 mg/dl, p=0.007) and glucose (117±8 and 115±12, vs. 83±3 mg/dl, p=0.002). HDL and triglycerides differed between S or SS and T (p<0.04). Cholesterol, HDL, and LDL were negatively related with nCD64, procalcitonin, CRP, glucose, LOS, and LOMV (p<0.05), but not with severity of illness. Glucose was positively related to the LOS and PELOD (p<0.05) and triglycerides with CRP (p<0.05).
Conclusions Lipoproteins and cholesterol are markedly reduced in severe sepsis, but not in trauma, and are inversely related to nCD64-expression, acute phase proteins, glucose, LOS, and LOMV.