Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Center for Research in Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
Nutrition. 2018 Nov;55-56:7-14. doi: 10.1016/j.nut.2018.04.007. Epub 2018 May 9.
Changes in lipid profiles occur in systemic inflammatory response syndrome (SIRS), whether due to sepsis or another cause. Hypocholesterolemia associated with hypertriacylglycerolemia can lead to disease severity and higher mortality. The aim of this systematic review was to describe the principal alterations in markers that participate in the alteration of the lipid profile.
We reviewed articles focused on alterations in the lipid profile in SIRS, sepsis, or both that were indexed in the Scientific Electronic Library Online from 2000 to 2017. The descriptors used were SIRS; sepsis; lipid profile; and lipoproteins. We focused in particular on the relationships among SIRS, sepsis, and lipid profiles.
We included 29 studies that discussed decreased high-density lipoprotein (HDL), total cholesterol, and low-density lipoprotein, and elevated triacylglycerols concentrations in patients with SIRS, sepsis, or both. The variation in the lipid profile was proportional to the level of inflammation as evaluated by inflammatory markers, including C-reactive protein, interleukin-6 and interleukin-8, lipopolysaccharide-binding protein, and tumor necrosis factor. Additionally, there was a change in the composition of lipoproteins, especially HDL, triacylglycerols, and very low-density lipoprotein. HDL appears to be an inflammatory marker, as reduction of its levels reflects the intensity of the underlying inflammatory process.
Critically ill patients with SIRS, sepsis, or both presented with alterations in lipid metabolism.
全身炎症反应综合征（SIRS）中会发生脂质谱变化，无论是由败血症还是其他原因引起。与高三酰甘油血症相关的低胆固醇血症可导致疾病严重程度增加和死亡率升高。本系统评价的目的是描述参与脂质谱改变的主要标志物的改变。
我们检索了 2000 年至 2017 年在科学电子图书馆在线（Scientific Electronic Library Online）索引的关于 SIRS、败血症或两者的脂质谱改变的文章。使用的描述符为 SIRS；败血症；脂质谱；和脂蛋白。我们特别关注 SIRS、败血症和脂质谱之间的关系。
我们纳入了 29 项讨论 SIRS、败血症或两者患者高密度脂蛋白（HDL）、总胆固醇和低密度脂蛋白降低以及三酰甘油浓度升高的研究。脂质谱的变化与炎症标志物（包括 C 反应蛋白、白细胞介素-6 和白细胞介素-8、脂多糖结合蛋白和肿瘤坏死因子）评估的炎症水平成正比。此外，脂蛋白的组成也发生了变化，尤其是 HDL、三酰甘油和极低密度脂蛋白。HDL 似乎是一种炎症标志物，因为其水平的降低反映了潜在炎症过程的强度。
患有 SIRS、败血症或两者的危重病患者存在脂质代谢改变。
