Serum Lipids and Lipoproteins During Uncomplicated Malaria: A Cohort Study in Lambaréné, Gabon

AbstractThe serum lipid profile in malaria patients has been found to differ from that of healthy controls. We investigated serum lipid profile changes in malaria patients over time compared with patients with other febrile diseases. In total, 217 patients were included in the study (111 malaria pat...

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Published in:	The American journal of tropical medicine and hygiene Vol. 96; no. 5; pp. 1205 - 1214
Main Authors:	Visser, Benjamin J, de Vries, Sophia G, Vingerling, Rieke, Gritter, Martin, Kroon, Danielle, Aguilar, Lídia Ciudad, Kraan, Rik B J, Wieten, Rosanne W, Danion, François, Sjouke, Barbara, Adegnika, Akim A, Agnandji, Selidji T, Kremsner, Peter G, Hänscheid, Thomas, Mens, Petra F, van Vugt, Michèle, Grobusch, Martin P
Format:	Journal Article
Language:	English
Published:	United States The American Society of Tropical Medicine and Hygiene 03-05-2017
Subjects:	Adult Antigens, Protozoan - blood Apolipoprotein A-I - blood Apolipoproteins B - blood Cholesterol, HDL - blood Cholesterol, LDL - blood Cohort Studies Diagnosis, Differential Female Fever - blood Fever - diagnosis Gabon Humans Lipid Metabolism Lipoprotein(a) - blood Malaria, Falciparum - blood Malaria, Falciparum - diagnosis Malaria, Falciparum - parasitology Male Parasitemia - blood Parasitemia - diagnosis Parasitemia - parasitology Plasmodium falciparum - growth & development Protozoan Proteins - blood ROC Curve Triglycerides - blood
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Summary:	AbstractThe serum lipid profile in malaria patients has been found to differ from that of healthy controls. We investigated serum lipid profile changes in malaria patients over time compared with patients with other febrile diseases. In total, 217 patients were included in the study (111 malaria patients and 106 symptomatic controls, defined as malaria-negative febrile patients). Serum lipid levels (mmol/L) were significantly lower in malaria patients compared with those with other febrile diseases (total cholesterol [TC] = 3.26 [standard deviation = 0.94] versus 3.97 [1.22; < 0.001]; high-density lipoprotein cholesterol [HDL-C] = 0.43 [0.47] versus 1.05 [0.67; < 0.001], low-density lipoprotein cholesterol [LDL-C] = 2.05 [0.76] versus 2.42 [0.90; < 0.001]. Triglycerides (TGs) levels were higher in malaria patients (1.81 [1.02] versus 1.11 [0.82; < 0.001]). No significant differences were found for apolipoprotein A1, apolipoprotein B, and lipoprotein(a). Cholesterol levels increased toward reference values on day 28 (TC = 3.26-3.98, < 0.001; HDL-C = 0.43-0.96, < 0.001; LDL-C = 2.05-2.60, < 0.001). TG levels decreased from 1.81 on admission to 1.76 (day 3) and 0.88 (day 28; = 0.130). Lipid profile changes were not correlated with parasitemia or histidine-rich protein 2 levels. This study confirms characteristic temporary lipid profile changes in malaria. Lipid profile changes demonstrated a good accuracy to discriminate between malaria and other febrile diseases (area under the curve = 0.80 (95% confidence interval = 0.742-0.863, < 0.001). Several plausible hypotheses exist regarding the pathophysiology of lipid profile changes in malaria. Further studies to elucidate the precise pathways may lead to improved understanding of the underlying pathophysiology.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-9637 1476-1645
DOI:	10.4269/ajtmh.16-0721