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2015 ; 32
(2
): 183-8
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Paraoxonase 1 Activity and Survival in Sepsis Patients
#MMPMID26167343
?nal V
; Yamanel L
; Ta?k?n G
; Tapan S
; Cömert B
Balkan Med J
2015[Apr]; 32
(2
): 183-8
PMID26167343
show ga
BACKGROUND: Sepsis is a state of augmented oxidative stress and diminished
antioxidant capacity. High density lipoprotein (HDL) particles were shown to
possess antioxidant and anti-inflammatory properties, as well as Paraoxonase 1
(PON1), which is an enzyme that is also protective against HDL oxidation.
Previous studies suggested a possible role of decreased PON1 activity or HDL
levels in sepsis patients. AIMS: The present study was designed to test a
hypothesis that higher PON1 activity and HDL-cholesterol levels could predict a
better survival in sepsis patients. STUDY DESIGN: Observational study. METHODS:
Venous blood samples were collected from sepsis patients for HDL-cholesterol
levels, PON1 activity and cytokine assays (TNF-? and IL-6) and Acute Physiologic
and Chronic Health Evaluation II (APACHE II) scores were calculated in order to
weight patients' disease severity on the day of sepsis diagnosis. Patients were
followed-up until the 28(th) day for any cause intra-hospital mortality. Data
were statistically analyzed for effects of study parameters on patients'
survival. RESULTS: In total, 85 patients with sepsis were included in the study.
The mean age was 65.2±17.9 years and 48 were male; at the end of the 28-day
follow-up period, 46 survived. TNF-? (86.9±10.5 vs 118.6±16.4) and IL-6 levels
(906.7±82.7 vs 1323.1±54.3) were significantly higher in non-survivors, while
PON1 activity (140.7±42.3 vs 66.7±46.6) and HDL-cholesterol levels (43.6±8.1 vs
34.5±8.9) were significantly higher in survivors (p<0.001 for all). TNF-?
(r=-0.763) and IL-6 levels (r=-0.947) showed strong negative correlations, PON1
activity (r=0.644) and HDL-cholesterol levels (r=0.477) showed positive
correlations with patient survival (p<0.001 for all). Survival estimates
significantly favored TNF-? (Log Rank 59.5, p<0.001) and IL-6 levels (Log Rank
53.2, p<0.001) according to PON1 activity (Log Rank 5.4, p<0.03) and
HDL-cholesterol levels (Log Rank 8.3, p<0.005). Regression analyses for relative
contributions of parameters to survival showed that higher IL-6 levels (t:
-16.489, p<0.001) were the most significant negative factor for survival, and
TNF-? levels (t: -4.417, p<0.001), whereas PON1 activity had a positive effect
(t:3.210, p<0.003). CONCLUSION: The present study showed that although low PON1
activity and HDL-cholesterol levels were related to mortality, higher levels were
not found to be as predictive as cytokine levels for survival.
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