Serum lipids and lipoproteins during uncomplicated malaria: a cohort study in Lambarene, Gabon

Benjamin J. Visser, Sophia G. de Vries, Rieke Vingerling, Martin Gritter, Danielle Kroon, Ldia Ciudad Aguilar, Rik B. J. Kraan, Rosanne W. Wieten, Francois Danion, Barbara Sjouke, Akim A. Adegnika, Selidji T. Agnandji, Peter G. Kremsner, Thomas Haenscheid, Petra F. Mens, Michele van Vugt, Martin P. Grobusch

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Abstract

The 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; P < 0.001]; high-density lipoprotein cholesterol [HDL-C] = 0.43 [0.47] versus 1.05 [0.67; P < 0.001], low-density lipoprotein cholesterol [LDL-C] = 2.05 [0.76] versus 2.42 [0.90; P < 0.001]. Triglycerides (TGs) levels were higher in malaria patients (1.81 [1.02] versus 1.11 [0.82; P < 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, P < 0.001; HDL-C = 0.43-0.96, P < 0.001; LDL-C = 2.05-2.60, P < 0.001). TG levels decreased from 1.81 on admission to 1.76 (day 3) and 0.88 (day 28; P = 0.130). Lipid profile changes were not correlated with parasitemia or Plasmodium falciparum 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, P < 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.

Original languageEnglish
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume96
Issue number5
Pages (from-to)1205-1214
Number of pages10
ISSN0002-9637
DOIs
Publication statusPublished - 2017

Keywords

  • PLASMODIUM-VIVAX-MALARIA
  • CORONARY-HEART-DISEASE
  • CHOLESTEROL ACYLTRANSFERASE
  • FALCIPARUM-MALARIA
  • HDL-CHOLESTEROL
  • METABOLISM
  • INFECTION
  • DIAGNOSIS
  • ENDOTOXIN
  • TRAVELERS

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