Low serum concentration of apolipoprotein A-I is an indicator of poor prognosis in cirrhotic patients with severe sepsis

Ming Hung Tsai, Yun Shing Peng, Yung Chang Chen, Jau Min Lien, Ya Chung Tian, Ji Tseng Fang, Hsu Huei Weng, Pang Chi Chen, Chih Wei Yang, Cheng Shyong Wu

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)

Abstract

Background/Aims: Severe sepsis is frequently associated with hypocholesterolemia which is also a common finding in cirrhotic patients. Lipoprotein is capable of binding endotoxin to which cirrhotic patients exhibit an excessive pro-inflammatory response. Methods: We evaluated the relationship between lipid levels, inflammatory cytokines and clinical outcomes in 103 cirrhotic patients with severe sepsis. Results: The non-survivors had significantly lower concentrations of total cholesterol, high-density lipoprotein (HDL), and apolipoprotein A-I (APO A-I). HDL and APO A-I levels were inversely correlated with interleukin-6, tumor necrosis factor-α, and various disease severity scores. Serum creatinine, mean arterial pressure and low level of APO A-I (<47.5 mg/dl) were independent factors to predict 90-day mortality. The cumulative survival rates at 90 days were 63.8% and 8.9% for the high APO A-I and low APO A-I groups (p < 0.0001). Low APO A-I was also associated with lower mean arterial pressure, higher rate of vasopressor dependency, and greater plasma renin activity. Conclusions: Serum levels of HDL and APO A-I are inversely correlated with liver reserve and disease severity in cirrhotic patients with severe sepsis. Low level of APO A-I is associated with a marked impairment of effective arterial volume, multiple organ dysfunction and a poor prognosis.

Original languageEnglish
Pages (from-to)906-915
Number of pages10
JournalJournal of Hepatology
Volume50
Issue number5
DOIs
Publication statusPublished - May 2009

Keywords

  • Apolipoprotein A-I liver cirrhosis
  • HDL
  • Severe sepsis

ASJC Scopus subject areas

  • Hepatology

Fingerprint

Dive into the research topics of 'Low serum concentration of apolipoprotein A-I is an indicator of poor prognosis in cirrhotic patients with severe sepsis'. Together they form a unique fingerprint.

Cite this