Quantitative and Qualitative Assessments of Cholesterol Association With Bacterial Infection Type in Sepsis and Septic Shock

Lauren Page Black, Michael A. Puskarich, Morgan Henson, Taylor Miller, Srinivasa T. Reddy, Rosemarie Fernandez, Faheem W. Guirgis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Reduced cholesterol levels are associated with increased organ failure and mortality in sepsis. Cholesterol levels may vary by infection type (gram negative vs positive), possibly reflecting differences in cholesterol-mediated bacterial clearance. Methods: This was a secondary analysis of a combined data set of 2 prospective cohort studies of adult patients meeting Sepsis-3 criteria. Infection types were classified as gram negative, gram positive, or culture negative. We investigated quantitative (levels) and qualitative (dysfunctional high-density lipoprotein [HDL]) cholesterol differences. We used multivariable logistic regression to control for disease severity. Results: Among 171 patients with sepsis, infections were gram negative in 67, gram positive in 46, and culture negative in 47. Both gram-negative and gram-positive infections occurred in 11 patients. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and HDL cholesterol (HDL-C) levels were lower for culture-positive sepsis at enrollment (TC, P <.001; LDL-C, P <.001; HDL-C, P =.011) and persisted after controlling for disease severity. Similarly, cholesterol levels were lower among culture-positive patients at 48 hours (TC, P =.012; LDL-C, P =.029; HDL-C, P =.002). Triglyceride (TG) levels were lower at enrollment (P =.033) but not at 48 hours (P =.212). There were no differences in dysfunctional HDL. Among bacteremic patients, cholesterol levels were lower at enrollment (TC, P =.010; LDL-C, P =.010; HDL-C, P ≤.001; TG, P =.005) and at 48 hours (LDL-C, P =.027; HDL-C, P <.001; TG, P =.020), except for 48 hour TC (P =.051). In the bacteremia subgroup, enrollment TC and LDL-C were lower for gram-negative versus gram-positive infections (TC, P =.039; LDL-C, P =.023). Conclusion: Cholesterol levels are significantly lower among patients with culture-positive sepsis and bacteremia.

Original languageEnglish (US)
Pages (from-to)808-817
Number of pages10
JournalJournal of Intensive Care Medicine
Volume36
Issue number7
DOIs
StatePublished - Jul 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The parent studies were supported by an NIGMS K23 (1K23GM115690-01A1 [Faheem W. Guirgis]) and a Society of Critical Care Medicine Vision Grant (Faheem W. Guirgis). The authors disclose the following salary support: NCATS 1KL2TROO1429 (Lauren Page Black); Minneapolis Medical Research Foundation (Michael A. Puskarich); Department of Defense W81XWH1810089; W81XWH-15-1-0403 (Rosemarie Fernandez); NIGMS 1K23GM115690-01A1 (Faheem W. Guirgis).

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The parent studies were supported by an NIGMS K23 (1K23GM115690-01A1 [Faheem W. Guirgis]) and a Society of Critical Care Medicine Vision Grant (Faheem W. Guirgis). The authors disclose the following salary support: NCATS 1KL2TROO1429 (Lauren Page Black); Minneapolis Medical Research Foundation (Michael A. Puskarich); Department of Defense W81XWH1810089; W81XWH-15-1-0403 (Rosemarie Fernandez); NIGMS 1K23GM115690-01A1 (Faheem W. Guirgis).

Publisher Copyright:
© The Author(s) 2020.

Keywords

  • culture positive
  • gram negative
  • gram positive
  • lipids
  • organ failure

PubMed: MeSH publication types

  • Journal Article

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