TRENDS IN CHOLESTEROL AND LIPOPROTEINS ARE ASSOCIATED WITH ACUTE RESPIRATORY DISTRESS SYNDROME INCIDENCE AND DEATH AMONG SEPSIS PATIENTS.

Autor:	Black LP; Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois., Hopson C; Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida., Barker G; Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida., Munson T; Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida., Henson M; Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida., Bertrand A; Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida., Daly-Crews K; Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida., Reddy ST; Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California., Guirgis FW; Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida.
Jazyk:	angličtina
Zdroj:	Shock (Augusta, Ga.) [Shock] 2024 Feb 01; Vol. 61 (2), pp. 260-265. Date of Electronic Publication: 2023 Dec 28.
DOI:	10.1097/SHK.0000000000002295
Abstrakt:	Abstract: Objective: Compare changes in cholesterol and lipoprotein levels occurring in septic patients with and without acute respiratory distress syndrome (ARDS) and by survivorship. Methods: We reanalyzed data from prospective sepsis studies. Cholesterol and lipoprotein levels were analyzed using univariate testing to detect changes between septic patients with or without ARDS, and among ARDS survivors compared with nonsurvivors at enrollment (first 24 h of sepsis) and 48 to 72 h later. Results: 214 patients with sepsis were included of whom 48 had ARDS and 166 did not have ARDS. Cholesterol and lipoproteins among septic ARDS versus non-ARDS showed similar enrollment levels. However, 48 to 72 h after enrollment, change in median total cholesterol (48/72 h - enrollment) was significantly different between septic ARDS (-4, interquartile range [IQR] -23.5, 6.5, n = 35) and non-ARDS (0, -10.0, 17.5, P = 0.04; n = 106). When compared by ARDS survivorship, ARDS nonsurvivors (n = 14) had lower median total cholesterol levels (75.5, IQR 68.4, 93.5) compared with ARDS survivors (113.0, IQR 84.0, 126.8, P = 0.022), and lower median enrollment low-density lipoprotein cholesterol (LDL-C) levels (27, IQR 19.5-34.5) compared with ARDS survivors (43, IQR 27-67, P = 0.013; n = 33). Apolipoprotein A-I levels were also significantly lower in ARDS nonsurvivors (n = 14) (87.6, IQR 76.45-103.64) compared with ARDS survivors (130.0, IQR 73.25-165.47, P = 0.047; n = 33). At 48 to 72 h, for ARDS nonsurvivors, median levels of low-density lipoprotein cholesterol (9.0, IQR 4.3, 18.0; n = 10), LDL-C (17.0, IQR 5.0, 29.0; n = 9), and total cholesterol (59.0, 45.3, 81.5; n = 10) were significantly lower compared with ARDS survivors' (n = 25) levels of low-density lipoprotein cholesterol (20.0, IQR 12.0-39.0, P = 0.014), LDL-C (42.0, IQR 27.0-58.0, P = 0.019), and total cholesterol (105.0, IQR 91.0, 115.0, P = 0.003). Conclusions: Change in total cholesterol was different in septic ARDS versus non-ARDS. Total cholesterol, LDL-C, and apolipoprotein A-I levels were lower in ARDS nonsurvivors compared with survivors. Future studies of dysregulated cholesterol metabolism in septic ARDS patients are needed to understand biology and links to potential therapies. Competing Interests: The authors report no conflict of interests. (Copyright © 2023 by the Shock Society.)
Databáze:	MEDLINE
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