The delta high-density lipoprotein cholesterol ratio: a novel parameter for gram-negative sepsis

OBJECTIVE To study changes in blood lipid metabolism in sepsis patients, especially high-density lipoprotein cholesterol (HDL-C) changes in the diagnosis of sepsis and the type of bacteria involved. METHODS Two-hundred-twenty cases of patients with febrile infections were divided into local infection, systemic inflammatory response syndrome or sepsis (sepsis) group. For controls, 81 cases of patients with a healthy check-up were used. Lipid levels and inflammatory state were supervised, and a comparative analysis of patients admitted to the hospital after 1, 5, 10 days was performed. RESULTS In patients with sepsis, total cholesterol, HDL-C, and apolipoprotein A 1 (apoA 1) were significantly decreased in this group. Particularly HDL-C was decreased 1 day after admission. Compared with the patients with gram-positive sepsis, HDL-C and apoA1 were significantly reduced in the patients with gram-negative sepsis at admission. The 24-h change ratio of HDL-C was different between the gram-negative and gram-positive sepsis patients with a 70.5 % specificity and 76.5 % sensitivity. The area under the curve was 0.744, and the critical value was -21.1 %. CONCLUSIONS The sepsis patients had lower HDL-C than the other groups. The 24-h change ratio of HDL-C can be used as a sepsis diagnosis maker and to distinguish between the bacteria involved in sepsis.