Martins Caroline Azevedo, Santos Maria Conceição B Dos, Gonçalves-de-Albuquerque Cassiano Felippe, Castro-Faria-Neto Hugo Caire, Castro-Faria Mauro Velho, Burth Patricia, Younes-Ibrahim Mauricio
Laboratório Integrado de Nefrologia, Department of Internal Medicine, Medical Sciences School, State University of Rio de Janeiro, Brazil.
Laboratório de Imunofarmacologia, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
Heliyon. 2021 Mar 8;7(3):e06420. doi: 10.1016/j.heliyon.2021.e06420. eCollection 2021 Mar.
Human leptospirosis is an acute infectious zoonosis presenting specific lipid disorders. Previous studies showed both leptospira glycolipoprotein endotoxin, and high oleic acid levels were associated with Na/K-ATPase inhibition that is amplified by the reduction of circulating albumin levels. In this study, we aimed to investigate the relationship of oleic acid/albumin (OA/A) molar ratio and clinical outcomes in Leptospirosis. Through a prospective observational cohort study employing high-performance liquid chromatography (HPLC) we sequentially determined serum concentrations of nonesterified fatty acids (NEFA) and albumin in twenty-eight patients with severe leptospirosis since their hospital admission. Twenty patients recovered, and eight died. Data was distributed in two groups according to clinical outcomes. Oleic acid/albumin molar ratios (OA/A), initial samples, were higher than those in healthy donors. The ratio OA/A, however, persisted high in dying patients, whereas patients who survived had a reduction matching to healthy donors. Biochemical alterations suggest that cure is correlated to the reestablishment of the OA/A molar ratio, while fatal outcomes related to persisting OA/A imbalances. Analysis by receiver operating characteristic (ROC) showed the area under the curve of 0.864 and the cutoff value of 0.715 being associated with a high odds ratio. Lipid analysis from patients with leptospirosis had an acute high serum OA/A molar ratio, and sustained imbalance has a high odds ratio and strong correlation with mortality.
人钩端螺旋体病是一种呈现特定脂质紊乱的急性感染性人畜共患病。先前的研究表明，钩端螺旋体糖脂蛋白内毒素和高油酸水平均与钠钾ATP酶抑制有关，而循环白蛋白水平降低会放大这种抑制作用。在本研究中，我们旨在调查油酸/白蛋白（OA/A）摩尔比与钩端螺旋体病临床结局之间的关系。通过一项采用高效液相色谱法（HPLC）的前瞻性观察队列研究，我们自入院起依次测定了28例重症钩端螺旋体病患者的血清非酯化脂肪酸（NEFA）和白蛋白浓度。20例患者康复，8例死亡。根据临床结局将数据分为两组。初始样本的油酸/白蛋白摩尔比（OA/A）高于健康供体。然而，在死亡患者中OA/A比值持续较高，而存活患者的该比值下降至与健康供体相当。生化改变表明，治愈与OA/A摩尔比的恢复相关，而致命结局与OA/A持续失衡有关。通过受试者工作特征（ROC）分析显示，曲线下面积为0.864，截断值为0.715，与高比值比相关。钩端螺旋体病患者的脂质分析显示血清OA/A摩尔比急性升高，持续失衡具有高比值比且与死亡率密切相关。
