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Lower LDL levels not directly tied to increased sepsis risk
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Lower LDL levels were significantly associated with increased risk for sepsis in patients admitted to the ICU with infections, but only when associated with other comorbidities, according to findings published in JAMA Network Open.
“Patients with low levels of LDL cholesterol have an increased risk of sepsis and worse outcomes; however, these studies do not answer the question whether LDL-C modifies the risk of sepsis and outcomes directly, or if it does so indirectly through the effects of comorbid illness,” QiPing Feng, PhD, of the division of clinical pharmacology, department of medicine at Vanderbilt University Medical Center, and colleagues wrote. “Understanding the link between LDL-C levels and sepsis is important because newer medications to lower lipid levels ... can reduce LDL-C concentrations to very low levels.”
The cohort study consisted of 61,502 white participants who had an ICD-9-CM code indicating infection and received an antibiotic within a day of hospital admission.
Among the cohort, 3,961 patients had clinically measured LDL levels (mean age, 64 years; 58% women) and 7,804 had a genetic risk score for LDL (mean age, 60 years; 54% men). The primary outcome was sepsis with secondary outcomes being an admission to an ICU and in-hospital death, researchers wrote.
Feng and colleagues found lower-measured LDL levels were significantly associated with risk for sepsis (OR = 0.86; 95% CI, 0.79-0.94) and ICU admission (OR = 0.85; 95% CI, 0.76-0.96). In-hospital mortality was not significantly associated with lower-measured LDL levels (OR = 0.8; 95% CI, 0.63-1).
None of the associations were statistically significant after adjustment for age, sex and comorbidity variables (OR for risk of sepsis = 0.96; 95% CI, 0.88-1.06; OR for ICU admission = 0.94; 95% CI, 0.83-1.06; OR for in-hospital death = 0.97; 95% CI, 0.76-1.22), the researchers wrote.
The LDL genetic risk score correlated with measured LDL levels (r = 0.24; P < 2.2 10-16) but was not significantly associated with any of the outcomes, Feng and colleagues wrote. – by Earl Holland Jr.
Disclosures: Feng reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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