Cholesterol levels and long-term rates of community-acquired sepsis.
Cholesterol levels and long-term rates of community-acquired sepsis.
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DOI：
10.1186/s13054-016-1579-8
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发表时间：
2016-12-23
期刊：
影响因子：
--
通讯作者：
Wang HE
中科院分区：
文献类型：
--
作者：
Guirgis FW;Donnelly JP;Dodani S;Howard G;Safford MM;Levitan EB;Wang HE
血脂异常是心血管疾病的危险因素，低密度脂蛋白胆固醇（LDL-C）升高和高密度脂蛋白胆固醇（HDL-C）降低被认为是急性冠状动脉事件的危险因素。研究表明，低胆固醇水平和急性脓毒症的不良结局之间存在关联。我们试图确定基线胆固醇水平和长期脓毒症发生率之间的关系。我们使用了来自卒中地理和种族差异原因（REGARDS）队列的数据，该队列是一个基于人群的队列，包括30，239名社区居住的成年人。主要结局为首次脓毒症事件，定义为在住院前28小时内因感染住院，且存在≥2项全身炎症反应综合征标准（体温、心率、呼吸频率、白色血细胞计数异常）。考克斯模型评估了HDL-C或LDL-C四分位数与首次脓毒症事件之间的相关性，调整了参与者人口统计学、健康行为、慢性疾病和生物标志物。我们纳入了29，690例具有可用基线HDL-C和LDL-C的受试者。有3423例因严重感染住院，1526例患者中共有1845例败血症事件。血清HDL-C四分位数与长期脓毒症发生率无关（风险比（HR）（95% CI）：Q1（HDL-C 5-40 mg/dl），1.08（0.91-1.28）; Q2（HDL-C 41-49 mg/dl），1.06（0.90-1.26）; Q3（HDL-C 50-61 mg/dl），1.04（0.89-1.23）; Q4，参考）。然而，与LDL-C的最高四分位数相比，低LDL-C与较高的脓毒症发生率相关（Q1（LDL-C 3-89 mg/dl），1.30（1.10-1.52）; Q2（LDL-C 90-111 mg/dl），1.24（1.06-1.47）; Q3（LDL-C 112-135 mg/dl），1.07（0.91-1.26）; Q4，参考）。低LDL-C与社区获得性脓毒症的长期发生率较高相关。HDL-C水平与长期脓毒症发生率无关。本文的在线版本（doi：10.1186/s13054-016-1579-8）包含补充材料，可供授权用户使用。
Dyslipidemia is a risk factor for cardiovascular disease, with elevated low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C) recognized as risk factors for acute coronary events. Studies suggest an association between low cholesterol levels and poor outcomes in acute sepsis. We sought to determine the relationship between baseline cholesterol levels and long-term rates of sepsis. We used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, a population-based cohort of 30,239 community-dwelling adults. The primary outcome was first sepsis event, defined as hospitalization for an infection with the presence of ≥2 systemic inflammatory response syndrome criteria (abnormal temperature, heart rate, respiratory rate, white blood cell count) during the first 28 hours of hospitalization. Cox models assessed the association between quartiles of HDL-C or LDL-C and first sepsis event, adjusted for participant demographics, health behaviors, chronic medical conditions, and biomarkers. We included 29,690 subjects with available baseline HDL-C and LDL-C. There were 3423 hospitalizations for serious infections, with 1845 total sepsis events among 1526 individuals. Serum HDL-C quartile was not associated with long-term rates of sepsis (hazard ratio (HR) (95% CI): Q1 (HDL-C 5–40 mg/dl), 1.08 (0.91–1.28); Q2 (HDL-C 41–49 mg/dl), 1.06 (0.90–1.26); Q3 (HDL-C 50–61 mg/dl), 1.04 (0.89–1.23); Q4, reference). However, compared with the highest quartile of LDL-C, low LDL-C was associated with higher rates of sepsis (Q1 (LDL-C 3–89 mg/dl), 1.30 (1.10–1.52); Q2 (LDL-C 90–111 mg/dl), 1.24 (1.06–1.47); Q3 (LDL-C 112–135 mg/dl), 1.07 (0.91–1.26); Q4, reference). Low LDL-C was associated with higher long-terms rates of community-acquired sepsis. HDL-C level was not associated with long-term sepsis rates. The online version of this article (doi:10.1186/s13054-016-1579-8) contains supplementary material, which is available to authorized users.
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