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HDL inflammatory index correlates with and predicts severity of organ failure in patients with sepsis and septic shock

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  • Faheem W Guirgis
  • Sunita Dodani
  • Christiaan Leeuwenburgh
  • Lyle Moldawer
  • Jennifer Bowman
  • Colleen Kalynych
  • Victor Grijalva
  • Srinivasa T Reddy
  • Alan E Jones
  • Frederick A Moore

Abstract

Objective: High density lipoprotein (HDL) is important for defense against sepsis but becomes dysfunctional (Dys-HDL) during inflammation. We hypothesize that Dys-HDL correlates with organ dysfunction (sequential organ failure assessment (SOFA) score) early sepsis. Methods: A prospective cohort study of adult ED sepsis patients enrolled within 24 hours. Results: Eighty eight patients were analyzed. Dys-HDL (expressed as HDL inflammatory index (HII)) correlated with SOFA at enrollment (r = 0.23, p = 0.024) and at 48 hours (r = 0.24, p = 0.026) but HII change over the first 48 hours did not correlate with change in SOFA (r = 0.06, p = 0.56). Enrollment HII was significantly different in patients with most severe organ failure (2.31, IQR 1.33–5.2) compared to less severe organ failure (1.81, IQR 1.23–2.64, p = 0.043). Change in HII over 48 hours was significantly different for in-hospital non-survivors (-0.45, IQR-2.6, -0.14 p = 0.015) and for 28-day non-survivors (-1.12, IQR -1.52, 0.12, p = 0.044). In a multivariable linear regression equation (R2 = 0.13), for each unit HII increase, 48-hour SOFA increased by 0.72 (p = 0.009). Conclusion: HII correlated with SOFA and predicted 48-hour SOFA score in early sepsis. Future studies are needed to delineate potential mechanisms. Trial registration: NCT02370186. Registered February 24, 2015.

Suggested Citation

  • Faheem W Guirgis & Sunita Dodani & Christiaan Leeuwenburgh & Lyle Moldawer & Jennifer Bowman & Colleen Kalynych & Victor Grijalva & Srinivasa T Reddy & Alan E Jones & Frederick A Moore, 2018. "HDL inflammatory index correlates with and predicts severity of organ failure in patients with sepsis and septic shock," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-13, September.
    • Handle: RePEc:plo:pone00:0203813
    DOI: 10.1371/journal.pone.0203813
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    1. Karen F. Kozarsky & Mary H. Donahee & Attilio Rigotti & Sohah N. Iqbal & Elazer R. Edelman & Monty Krieger, 1997. "Overexpression of the HDL receptor SR-BI alters plasma HDL and bile cholesterol levels," Nature, Nature, vol. 387(6631), pages 414-417, May.
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