Monocyte-to-HDL ratio and non-HDL cholesterol were predictors of septic shock in newborns

• DOI: 10.1016/j.clinsp.2022.100111
• Publication Date: 2022-11-08T18:28:26Z
• Authors: Fernanda Andrade ...; Aline Paulino Esp...; Maria Helena Bapt...; Valéria Sutti Nunes; Patricia Miralda ...; Guilherme Silva F...; Maria Esther Jurf...; Werther Brunow de...; Magda Carneiro-Sa...; Patricia Palmeira
• Keywords: Male; Interleukin-6; Lipoproteins; Cholesterol, HDL; Interleukin-8; Late-onset neonatal sepsis; Infant, Newborn; Monocyte-to-HDL ratio; Original Articles; Shock, Septic; Monocytes; 3. Good health; 03 medical and health sciences; Cholesterol; 0302 clinical medicine; Septic shock; Sepsis; Humans; Cytokines; Female; Prospective Studies; Neonatal Sepsis; Triglycerides

The association between lipoprotein levels and late-onset neonatal sepsis has shown controversial results. The aims are to assess lipid profile, cytokines, and Monocyte-to-HDL (M/H) ratio as diagnostic and prognostic markers for late-onset neonatal sepsis.This prospective study included 49 septic neonates and 17 controls. Cholesterol (CT), Triglyceride (TG), Very-Low-Density (VLDLc), Low-Density (LDLc), and High-Density Lipoproteins (HDLc) were measured at admission (D0) and on days 3, 7 and 10 to evaluate septic shock outcomes. Cytokines and monocytes were evaluated by flow cytometry.Septic newborns showed higher IL-6 and IL-8 at D0 and CT levels on D7 and on D10, which also presented higher TG, VLDLc and non-HDL cholesterol concentrations than controls. The septic shock group (n = 22) revealed a higher number of male subjects, CRP, IL-6, IL-8 and IL-10 levels, while lower TG, HDLc, monocyte numbers and M/H ratio at admission compared to the non-shock group (n = 27). M/H ratio and non-HDL cholesterol on D0 were risk factors for septic shock (OR = 0.70, 0.49‒0.99; OR = 0.96, 0.92‒0.99, respectively). Decreasing levels from D0 to D3 of CT (OR = 0.96, 0.93‒0.99), VLDLc (OR = 0.91, 0.85‒0.98), and non-HDL cholesterol (OR = 0.92, 0.87‒0.98) were also predictors of septic shock.Lower M/H ratios and non-HDL cholesterol at admission and decreasing levels of cholesterol, VLDLc and non-HDL cholesterol during a hospital stay are associated with the development of septic shock in newborns with late-onset neonatal sepsis.