Hypertriglyceridemia As A Marker Of Multi-Organ Dysfunction In Leptospirosis

Abstract

Background- Weil’s disease represents the most severe form and can develop after the acute phase as the second phase of a biphasic illness or as a progressive illness. It is characterised by jaundice, renal failure, bleeding disorders and altered mental status

Objectives-To find out association between Hypertriglyceridemia and Multi-Organ dysfunction in patients with Leptospirosis.

Methods- It was a prospective cross sectional study. Fifty consecutive patients who were diagnosed with Leptospirosis at the Department of Internal Medicine between February 2016 and September 2016 were included in the present study. The diagnosis of Leptospirosis was established by the presence of specific IgM antibodies against L. interrogans as determined by ELISA. No patient was receiving any hypolipidaemic agents or had any evidence of any disease known to affect lipid metabolism. All patients were examined on diagnosis and 4 months after recovery. No change in patients’ dietary habits and body weight was recorded during follow-up. Fifty age- and sex-matched healthy volunteers (control population) were also included. SPSS was used for analysis.

Results- The patients (49 male and 1 female, mean age 49.5 ± 8.4 years) presented with fever and myalgias, while 4 of them (36%) also presented with jaundice and acute renal failure. Patients with Leptospirosis had decreased levels of TC, HDL-C, LDL-C, Lp(a) and  whereas TG and VLDL-C levels as well were elevated compared with 4 months after recovery. Mean LDL particle size was decreased and sdLDL-C levels were increased at baseline compared with 4 months after recovery. Also, sdLDL-C% was markedly elevated at baseline compared with the values after recovery. According to these results, the only parameters significantly affected by creatinine levels were LDL-C and large LDL-C levels (p\0.05 for both). Levels of MODF markers (CRP, IL-1b, IL-6, and TNFa) were increased at baseline compared with 4 months and no difference in the levels of the inflammatory markers was observed between patients 4 months after the resolution of Leptospirosis.

Conclusion- Leptospirosis causes impressive alterations in the lipid profile that include markedly elevated TG which is considered as marker for multi-organ dysfunction and sdLDL-C concentration and low HDL-C and LDL-C levels.