Lipid and lipoprotein predictors of functional outcomes and long-term mortality after surgical sepsis.
Lipid and lipoprotein predictors of functional outcomes and long-term mortality after surgical sepsis.
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DOI：
10.1186/s13613-021-00865-x
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发表时间：
2021-05-20
影响因子：
8.1
通讯作者：
Moore FA
中科院分区：
文献类型：
--
作者：
Guirgis FW;Leeuwenburgh C;Moldawer L;Ghita G;Black LP;Henson M;DeVos E;Holden D;Efron P;Reddy ST;Moore FA
败血症是一种危及生命的、对感染的失调反应。包括胆固醇在内的脂质生物标志物在脓毒症期间被动态调节，并预测短期结果。在这项研究中，我们调查了脂类生物标志物对脓毒症后身体功能和长期死亡率的预测能力。脓毒症患者在脓毒症束启动后24小时内住进外科重症监护室(ICU)的前瞻性队列研究。样本是在登记时获得的，用于血脂生物标记物。多变量回归模型确定了独立的危险因素，预测表现不佳状态(Zubrod评分3/4/5)或1年随访存活率。这项研究包括104名外科脓毒症患者。登记的总胆固醇和高密度脂蛋白(HDL-C)水平在1年时较低，髓过氧化物酶(MPO)水平较高。在基于1年死亡率的比较中也看到了类似的趋势，死亡患者的高密度脂蛋白-C和载脂蛋白A-I水平较低，MPO水平较高。然而，多变量Logistic回归仅将基线Zubrod和初始SOFA评分确定为1年后表现不佳的显著独立预测因素。对1年存活期的多变量COX回归模型表明，Charlson合并症评分高、载脂蛋白A-I水平低、血管升压剂持续时间长是脓毒症后1年以上死亡率的预测因素。在这项外科脓毒症研究中，没有发现脂蛋白可以预测1年后的不良表现状态。载脂蛋白A-I水平、Charlson合并症评分和血管加压剂的使用时间可预测1年存活率。这些数据表明，胆固醇和脂蛋白是脓毒症的潜在病理生物学因素。网上版载有补充材料，可在10.1186/s13613-021-00865-x查阅。
Sepsis is a life-threatening, dysregulated response to infection. Lipid biomarkers including cholesterol are dynamically regulated during sepsis and predict short-term outcomes. In this study, we investigated the predictive ability of lipid biomarkers for physical function and long-term mortality after sepsis. Prospective cohort study of sepsis patients admitted to a surgical intensive-care unit (ICU) within 24 h of sepsis bundle initiation. Samples were obtained at enrollment for lipid biomarkers. Multivariate regression models determined independent risk factors predictive of poor performance status (Zubrod score of 3/4/5) or survival at 1-year follow-up. The study included 104 patients with surgical sepsis. Enrollment total cholesterol and high-density lipoprotein (HDL-C) levels were lower, and myeloperoxidase (MPO) levels were higher for patients with poor performance status at 1 year. A similar trend was seen in comparisons based on 1-year mortality, with HDL-C and ApoA-I levels being lower and MPO levels being higher in non-survivors. However, multivariable logistic regression only identified baseline Zubrod and initial SOFA score as significant independent predictors of poor performance status at 1 year. Multivariable Cox regression modeling for 1-year survival identified high Charlson comorbidity score, low ApoA-I levels, and longer vasopressor duration as predictors of mortality over 1-year post-sepsis. In this surgical sepsis study, lipoproteins were not found to predict poor performance status at 1 year. ApoA-I levels, Charlson comorbidity scores, and duration of vasopressor use predicted 1 year survival. These data implicate cholesterol and lipoproteins as contributors to the underlying pathobiology of sepsis. The online version contains supplementary material available at 10.1186/s13613-021-00865-x.
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影响因子：
9
作者：
Brakenridge, Scott C.;Efron, Philip A.;Moore, Frederick A.
通讯作者：
Moore, Frederick A.
影响因子：
5.5
作者：
Beutler, B;Hoebe, K;Ulevitch, RJ
通讯作者：
Ulevitch, RJ
影响因子：
4.8
作者：
Kitchens, RL;Wolfbauer, G;Munford, RS
通讯作者：
Munford, RS
影响因子：
2.9
作者：
Loftus TJ;Mira JC;Ozrazgat-Baslanti T;Ghita GL;Wang Z;Stortz JA;Brumback BA;Bihorac A;Segal MS;Anton SD;Leeuwenburgh C;Mohr AM;Efron PA;Moldawer LL;Moore FA;Brakenridge SC
通讯作者：
Brakenridge SC
清道夫受体 BI 和高密度脂蛋白调节脓毒症中胸腺细胞凋亡。
DOI：
10.1161/atvbaha.113.302484
发表时间：
2014-05
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
Guo L;Zheng Z;Ai J;Howatt DA;Mittelstadt PR;Thacker S;Daugherty A;Ashwell JD;Remaley AT;Li XA
通讯作者：
Li XA