Apolipoprotein A-V is not a major determinant of triglyceride levels during human sepsis.

Purpose: During critical illnesses, alterations in lipid metabolism occur. We examined levels of apolipoprotein A-V, a novel regulator of triglyceride metabolism, during sepsis in humans.

Methods: Seventy-five cases of sepsis and 75 cases of acute illnesses not associated with infection were recruited. Lipids and apolipoprotein A-V levels were measured by enzymatic methods and enzyme-linked immunosorbent assay, respectively, within 24 hours of diagnosis. Fifty healthy controls were also enrolled.

Results: During sepsis and acute illnesses, serum total cholesterol and high-density lipoprotein cholesterol levels were significantly lower than those in controls. Serum triglyceride levels, however, were not significantly different. Similarly, serum apolipoprotein A-V levels during sepsis were not significantly different from those during acute illnesses and those in controls (expressed as median [interquartile range]: 149.6 [97.5-257.1] vs 157.9 [98.4-238.2] and 155.9 [91.5-253.8] ng/mL, respectively; P = .98); and they were not correlated with serum triglyceride levels. Low apolipoprotein A-V levels were associated with higher mortality, but the association became nonsignificant after adjusting for high-density lipoprotein cholesterol levels.

Conclusions: During sepsis or acute illnesses, serum apolipoprotein A-V levels were not significantly different from those in controls. Furthermore, apolipoprotein A-V levels were not linearly correlated with triglyceride levels, suggesting that it might not be a major determinant of triglyceride levels during sepsis.