Tsimihodimos Vasilis, Kei Anastazia, Apostolou Fotini, Elisaf Moses
a Department of Internal Medicine , Medical School, University of Ioannina , Ioannina , Greece.
Hosp Pract (1995). 2018 Oct;46(4):229-232. doi: 10.1080/21548331.2018.1483171. Epub 2018 Jun 6.
Visceral leishmaniasis (VL) has been associated with the increase in triglyceride (TG) levels and the decrease in high-density lipoprotein cholesterol (HDL-C) concentration. The aim of the study was to evaluate whether there is a diagnostic cut-off point in these lipid profile changes.
We included 100 patients with febrile infections. Analytically, 22 patients with VL, 18 patients with leptospirosis, 20 patients with Brucella melitensis, and 40 age- and sex-matched patients with fever and proven bacteremia (endocarditis and pyelonephritis). The lipid parameters were assessed for their diagnostic accuracy using logistic regression and receiver operating characteristic statistics.
It was observed that coexistence of HDL-C < 15 mg/dL and ΤG > 180 mg/dL had 100% sensitivity and 67.5% specificity for the confirmation of VL. The corresponding positive and negative predictive values were 59.4% and 100%, respectively.
Coexistence of high TGs and low HDL-C values may suggest VL infection in a febrile patient.
内脏利什曼病(VL)与甘油三酯(TG)水平升高及高密度脂蛋白胆固醇(HDL-C)浓度降低有关。本研究的目的是评估这些血脂谱变化中是否存在诊断临界点。
我们纳入了100例发热感染患者。分析时,包括22例VL患者、18例钩端螺旋体病患者、20例羊布鲁氏菌病患者以及40例年龄和性别匹配的发热且确诊为菌血症(心内膜炎和肾盂肾炎)的患者。使用逻辑回归和受试者工作特征统计分析评估血脂参数的诊断准确性。
观察到HDL-C<15mg/dL且TG>180mg/dL同时存在时,确诊VL的敏感性为100%,特异性为67.5%。相应的阳性和阴性预测值分别为59.4%和100%。
高TG和低HDL-C值同时存在可能提示发热患者感染了VL。