ArticleCritical care (London, England)2023
Low levels of small HDL particles predict but do not influence risk of sepsis.
Article in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 24 citations in OpenAlex.
- Admission lipid profile and outcomes in sepsis requiring early invasive source control.BMC infectious diseases · 2026Observational
- Serum HDL subfractions are impaired by COVID-19 vaccine in patients with thymic epithelial tumors.Scientific reports · 2026Article
- Evidence of immune-metabolic imbalance prior to sepsis: a prospective study in the UK Biobank.Frontiers in nutrition · 2026Article
- The high-sensitivity C-reactive protein-to-high-density lipoprotein cholesterol ratio as a novel composite biomarker for predicting 28-day all-cause mortality in sepsis: a retrospective cohort study.Frontiers in medicine · 2026Article
- Metabolic syndrome and risk of sepsis and sepsis-related mortality: evidence from two large prospective cohort studies.Military Medical Research · 2026Article
- Association of Modifiable Lifestyle and Metabolic Factors With the Risk of Developing Sepsis: 2-Sample Mendelian Randomized Study.Interactive journal of medical research · 2025Article
- Adiposity, metabolites and endometrial cancer risk: inference from combinations of Mendelian randomization and observational analyses.BMC cancer · 2025Observational
- Mendelian Randomization and Infection: Pitfalls and Promises.The Journal of infectious diseases · 2025Review
- Plasma Metabolomic Biomarkers of Middle-Adulthood to Late-Adulthood Atopic Dermatitis: A Prospective Cohort Study From the UK Biobank.Allergy, asthma & immunology research · 2025Article
- Circulating metabolic biomarkers predict incident sepsis: a large-scale population study in the UK Biobank.Nutrition journal · 2025Article
- Association of healthy sleep patterns with incident sepsis: a large population-based prospective cohort study.Critical care (London, England) · 2025Article
- Association of Small HDL Subclasses with Mortality Risk in Chronic Kidney Disease.Antioxidants (Basel, Switzerland) · 2024Article
- ABCA1 and apoA-I dependent 12-hydroxyeicosatetraenoic acid efflux regulates macrophage inflammatory signaling.bioRxiv : the preprint server for biology · 2024Article
- High-density lipoprotein cholesterol as a prognostic marker for 90-day transplant-free mortality in hepatitis B virus-related acute-on-chronic liver failure.Frontiers in cellular and infection microbiology · 2024Article
- The Role of Interferon-Induced Proteins with Tetratricopeptide Repeats 1 and 2 in Sepsis-Induced Acute Liver Injury.Infection and drug resistance · 2024Article
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Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundLow levels of high-density lipoprotein (HDL) cholesterol have been associated with higher rates and severity of infection. Alterations in inflammatory mediators and infection are associated with alterations in HDL cholesterol. It is unknown whether the association between HDL and infection is present for all particle sizes, and whether the observed associations are confounded by IL-6 signalling.
methodsIn the UK Biobank, ~ 270,000 individuals have data on HDL subclasses derived from nuclear magnetic resonance analysis. We estimated the association of particle count of total HDL and HDL subclasses (small, medium, large, and extra-large HDL) with sepsis, sepsis-related death, and critical care admission in a Cox regression model. We subsequently utilised genetic data from UK Biobank and FinnGen to perform Mendelian randomisation (MR) of each HDL subclass and sepsis to test for a causal relationship. Finally, we explored the role of IL-6 signalling as a potential causal driver of changes in HDL subclasses.
resultsIn observational analyses, higher particle count of small HDL was associated with protection from sepsis (Hazard ratio, HR 0.80; 95% CI 0.74-0.86, p = 4 × 10
conclusionsLow number of small HDL particles are associated with increased hazard of sepsis, sepsis-related death, and sepsis-related critical care admission. However, genetic analyses did not strongly support this as causal. Instead, we demonstrate that increased IL-6 signalling, which is known to alter infection risk, could confound associations with reduced HDL particle count, and suggest this may explain part of the observed association between (small) HDL particle count and sepsis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.