Monocyte-to-HDL ratio and non-HDL cholesterol were predictors of septic shock in newborns

Author(s)

Fernanda Andrade Macaferri da Fonseca ^[1] ; Aline Paulino Espósito ; Maria Helena Baptista Nunes da Silva ^[3] ; Valéria Sutti Nunes ^[4] ; Patricia Miralda Cazita ^[5] ; Guilherme Silva Ferreira ^[6] ; Maria Esther Jurfest Rivero Ceccon ^[7] ; Werther Brunow de Carvalho ^[8] ; Magda Carneiro-Sampaio ^[9] ; Patricia Palmeira

Affiliation

^[1] Universidade de Sao Paulo. Faculdade de Medicina FMUSP. Departamento de Pediatria - Brasil

^[3] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas - Brasil

^[4] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas - Brasil

^[5] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas - Brasil

^[6] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas - Brasil

^[7] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas - Brasil

^[8] Universidade de Sao Paulo. Faculdade de Medicina FMUSP. Departamento de Pediatria - Brasil

^[9] Universidade de Sao Paulo. Faculdade de Medicina FMUSP. Departamento de Pediatria - Brasil

• Document type: Journal article
• Source: Clinics; v. 77, 2023-01-09.

Abstract

Abstract Background The association between lipoprotein levels and late-onset neonatal sepsis has shown controversial results. The aims are to assess lipid profile, cytokines, and Monocyte-to-HDL (M/H) ratio as diagnostic and prognostic markers for late-onset neonatal sepsis. Methods This prospective study included 49 septic neonates and 17 controls. Cholesterol (CT), Triglyceride (TG), Very-Low-Density (VLDLc), Low-Density (LDLc), and High-Density Lipoproteins (HDLc) were measured at admission (D0) and on days 3, 7 and 10 to evaluate septic shock outcomes. Cytokines and monocytes were evaluated by flow cytometry. Results Septic newborns showed higher IL-6 and IL-8 at D0 and CT levels on D7 and on D10, which also presented higher TG, VLDLc and non-HDL cholesterol concentrations than controls. The septic shock group (n = 22) revealed a higher number of male subjects, CRP, IL-6, IL-8 and IL-10 levels, while lower TG, HDLc, monocyte numbers and M/H ratio at admission compared to the non-shock group (n = 27). M/H ratio and non-HDL cholesterol on D0 were risk factors for septic shock (OR = 0.70, 0.49‒0.99; OR = 0.96, 0.92‒0.99, respectively). Decreasing levels from D0 to D3 of CT (OR = 0.96, 0.93‒0.99), VLDLc (OR = 0.91, 0.85‒0.98), and non-HDL cholesterol (OR = 0.92, 0.87‒0.98) were also predictors of septic shock. Conclusions Lower M/H ratios and non-HDL cholesterol at admission and decreasing levels of cholesterol, VLDLc and non-HDL cholesterol during a hospital stay are associated with the development of septic shock in newborns with late-onset neonatal sepsis. (AU)

• FAPESP's process: 16/06887-5 - STUDY OF PROTEIN BIOMARKERS AND GENE EXPRESSION PROFILE OF NF-˜B PATHWAY IN LATE-ONSET NEONATAL SEPSIS: POTENTIAL VALUE IN DIAGNOSIS AND PROGNOSIS
• Grantee: Patricia Palmeira Daenekas Jorge
• Support Opportunities: Regular Research Grants