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

研究成果: 雜誌貢獻文章同行評審

48 引文 斯高帕斯(Scopus)

摘要

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.

原文英語
頁(從 - 到)906-915
頁數10
期刊Journal of Hepatology
50
發行號5
DOIs
出版狀態已發佈 - 五月 2009

ASJC Scopus subject areas

  • 肝病

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