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  • Open Access

Decreased apolipoprotein A1 levels correlate with sepsis and adverse outcome among ICU patients

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Critical Care200812 (Suppl 2) :P201

  • Published:


  • Adverse Outcome
  • Septic Patient
  • Serum Amyloid
  • Lipoprotein Metabolism
  • Lipoprotein Level


Although changes in lipoprotein levels occur in a variety of inflammatory disorders, little is known about lipoprotein metabolism among septic patients. This study investigated the dynamics of plasma apolipoprotein A1 (apoA1), as well as other inflammatory markers, in ICU patients with and without sepsis.


Sixty patients (34 with sepsis and 26 without) on mechanical ventilation, mean age 51 ± 19.6 years, mean ICU stay 24 ± 18.8 days, APACHE II score 13 ± 6.8, admitted directly to our ICU were enrolled in our study. Three blood samples were collected on day 0, on day 7 or the day of sepsis onset and on day 15 for the determination of plasma apoA1, C-reactive protein and serum amyloid A levels by the nephelometric technique (BNProSpec; Dade-Behring).


Among septic patients apoA1 levels decreased from 81.9 ± 28.3 on day 0 to 56.2 ± 16.0 mg/dl the on day of sepsis onset (63.2 ± 14.4 and 50.6 ± 15.4 mg/dl for survivors and non-survivors, respectively). On day 15, surviving patients demonstrated increasing values (79.3 ± 16.4 mg/dl); the opposite was true for nonsurvivors (30.3 ± 15.4 mg/dl on the third sample). Among nonseptic patients, the apoA1 values corresponded to 92.8 ± 26.2 on day 0, 85.2 ± 19.3 on day 7, and 87.2 ± 20.9 mg/dl on day 15. Significantly different levels (paired Student's t test, P < 0.05) were detected between septic and nonseptic patients on day 7 or on the day of sepsis onset, between surviving sepsis and nonsurviving sepsis patients on the same day, and between surviving sepsis and nonsurviving sepsis patients on day 15. C-reactive protein and serum amyloid A concentrations showed no difference between patients who survived and those who passed away (second or third sample).


Among ICU patients with sepsis, the apoA1 concentrations decrease rapidly, but not in nonseptic patients. Low apoA1 levels on the day of onset of sepsis appear to be a predictive factor for adverse outcome.

Authors’ Affiliations

KAT General Hospital, Athens, Greece
Atticon, Athens, Greece


© BioMed Central Ltd 2008

This article is published under license to BioMed Central Ltd.