Changes in serum lipoprotein pattern induced by acute infections

doi:10.1016/0026-0495(88)90120-5

Metabolism

Volume 37, Issue 9, September 1988, Pages 859-865

https://doi.org/10.1016/0026-0495(88)90120-5 Get rights and content

Abstract

To study the effects of acute infections on serum lipids and lipoproteins we measured the concentration and composition of different lipoproteins, apoproteins A-I, A-II, and B, and the activities of plasma postheparin lipolytic enzymes, lipoprotein lipase (LPL) and hepatic lipase (HL) during acute and convalescence phase and after complete recovery in 72 infectious patients (33 with viral infection and 39 with bacterial infection). The mass concentrations of both low density lipoprotein (LDL) (P < .001) and high density lipoprotein (HDL)₂ (P < .002) were reduced during acute infections due to the lowering of their cholesterol, phospholipid, and protein contents. The reduction of LDL cholesterol was maximal at the acute stage of infection (change −15%, P < .001) while the reduction of HDL₂ cholesterol was maximal during the convalescence (change −35%, P < .001). During acute infections LDL became triglyceride-enriched (11.8 v 8.6%, P < .0001) but cholesterol-poor (36.6 v 39.3%, P < .0001). The ratio of HDL cholesterol/LDL cholesterol was significantly reduced during the convalescence (0.42 ± 0.15 v 0.53 ± 0.19, P < .0001). The concentrations of apo A-I and apo A-II were decreased during acute infections (changes −22%, P < .001, and −16%, P < .001, respectively). The very low density lipoprotein (VLDL) was 18% higher during the convalescence period than after the recovery due to the elevations of VLDL triglycerides, cholesterol, and phospholipids. The activity of LPL was reduced both in the acute and convalescence phase, whereas that of HL was reduced only in the acute phase of infections. The observed changes of the lipoproteins and lipase activities were related to the severity of infection but were independent of the infective agents. In conclusion, the concentration and composition of serum lipoproteins exhibit striking changes during acute infections which can be explained at least partly by the concomitant reductions of LPL and HL activities.

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A recent clinical case report showed changes in serum syndecan-1 level closely reflected the change in disease conditions in a patient with COVID-19.33 Moreover, recent studies have also shown decreased LPL caused by the inflammatory response.28,34,35 Interestingly, recent studies also suggested an effect of triglyceride on promoting inflammation.
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To investigate the association between alteration in triglyceride level and mortality in hospitalized COVID-19 patients.
We conducted a retrospective study of 600 hospitalized patients with COVID-19 diagnosis (ICD10CM:U07.1) and/or SARS-CoV-2 positive testing results between March 1, 2020 and December 21, 2020 at a tertiary academic medical center in Milwaukee, Wisconsin. De-identified data, including demographics, medical history, and blood triglyceride levels were collected and analyzed. Of the 600 patients, 109 patients died. The triglyceride value on admission was considered the baseline and the peak was defined as the highest level reported during the entire period of hospitalization. Hypertriglyceridemia was defined as greater than 150 mg/dl. Logistic regression analyses were performed to evaluate the association between hypertriglyceridemia and mortality.
There was no significant difference in baseline triglyceride levels between non-survivors (n = 109) and survivors (n = 491) [Median 127 vs. 113 mg/dl, p = 0.213]. However, the non-survivors had significantly higher peak triglyceride levels during hospitalization [Median 179 vs. 134 mg/dl, p < 0.001]. Importantly, hypertriglyceridemia independently associated with mortality [odds ratio=2.3 (95% CI: 1.4–3.7, p = 0.001)], after adjusting for age, gender, obesity, history of hypertension and diabetes, high CRP, high leukocyte count and glucocorticoid treatment in a multivariable logistic regression model.
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A retrospective analysis was performed in 13,478 participants selected from the Atherosclerosis Risk in Communities (ARIC) study, a large community-based longitudinal cohort in the United States with a median follow-up time of >20 years. First incident of hospitalization for pneumonia was identified through hospital discharge records. Cox proportional hazard models were used to assess the association of baseline major lipid levels (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides) with time to first pneumonia hospitalization.
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^☆: Supported by grants from the Finnish Heart Foundation and the Sigrid Juselius Foundation, Helsinki, Finland.

^†: Deceased September 21, 1986.

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Changes in serum lipoprotein pattern induced by acute infections☆

Abstract

Metabolism

Clin Chim Acta

J Lipid Res

Clin Chim Acta

Steroids

Metabolism

J Surg Res

Metabolism

Atherosclerosis

Clin Chim Acta

Am Heart J

Lipids, lipoproteins, and apoproteins in serum during infection

Clin Chem

Serum lipids in infection

N Engl J Med

Serum lipids in viral and bacterial meningitis

Scand J Infect Dis

Dyslipoproteinemia in patients with severe bacterial infections

Scand J Infect Dis

Serum total lipids, lipoprotein cholesterol and apolipoprotein A in acute viral hepatitis and chronic liver disease

J Clin Pathol

Regulation of lipoprotein metabolism by endothelial lipolytic enzymes

Indices of obesity derived from body weight and height

Br J Prev Soc Med