• S Lüthold, K Berneis, P Bady, and B Müller.
• Division of Endocrinology, Diabetology and Clinical Nutrition, Department of Internal Medicine, University Hospital, Basel, Switzerland. samuel_luethold@postmail.ch
• Eur. J. Clin. Invest. 2007 Jul 1;37(7):573-9.

BackgroundPlasma lipids can be affected by acute illnesses. The present study attempts to characterize the impact of infectious disease on plasma lipids in critical illness. It also aims to determine the value of plasma lipid routine measurements in the diagnosis of infection in critical illness in comparison to markers of infection and acute phase reactants.Materials And MethodsAn observational study was carried out in 101 critically ill patients admitted consecutively to a medical intensive care unit in a university medical centre. Levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and additional variables were measured in blood samples taken on the day of admission.ResultsIn critically ill patients significantly lower levels of HDL-C and TC were found in infectious disease patients compared to non-infectious disease patients (P < 0.001). No significant differences in levels of TG were found between infectious and non-infectious disease patients. Using receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) value for HDL-C and TC in the diagnosis of infection was 0.791 (P < 0.001) and 0.730 (P < 0.001), respectively. At a cutoff value for HDL-C of ConclusionIn critically ill infected patients, HDL-C and TC levels are lower than in non-infected critically ill patients. In this study the diagnostic accuracy of CRP is not better than the one of HDL-C. The diagnostic accuracy of procalcitonin is superior to HDL-C.

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