Search

Background 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. Materials and methods 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. Results It was observed that coexistence of HDL-C 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. Conclusion Coexistence of high TGs and low HDL-C values may suggest VL infection in a febrile patient.

Objective Experimental studies have shown that the preβ-1 subclass of high-density lipoprotein particles (preβ-1 HDL) may play an important role in the reverse cholesterol transport pathway as the initial acceptors of cellular cholesterol. The aim of the present study was the direct comparison of preβ-1 HDL values in individuals with various types of primary dyslipidemias. Methods Four hundred and eighty-six unrelated individuals were included in the study. According to their lipid values study participants were subdivided into four groups: control group ( n = 206), type IIA dyslipidemia group ( n = 148), type IIB dyslipidemia group ( n = 49) and type IV dyslipidemia group ( n = 83). Results All dyslipidemic patients displayed higher concentrations of preβ-1 HDL compared to control individuals. However, patients with dyslipidemias characterized by an abnormal catabolism of triglyceride-rich lipoproteins (such as dyslipidemias of type IIB and IV) tend to have higher preβ-1 HDL values compared to patients with hypercholesterolemia, and this increase is proportional to the degree of hypertriglyceridemia. In addition, patients with metabolic syndrome exhibited significantly higher levels of preβ-1 HDL compared to individuals that do not fulfill the criteria for the diagnosis of this syndrome. Multiple regression analysis revealed that serum triglyceride concentrations and body mass index (BMI) values were the most important determinants of preβ-1 HDL levels in our population. Conclusion All dyslipidemic patients exhibit increased preβ-1 HDL concentrations as compared to normolipidemic individuals. Whether this increase represents a defensive mechanism against atherosclerosis or it is indicative of impaired maturation of HDL particles and thus of a defective reverse cholesterol transport mechanism remains to be established.