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Postsurgical reduction of serum lipoproteins: Interleukin-6 and the acute-phase response

  • Suat Akgün
    Correspondence
    Reprint requests: Suat Akgün, MD, Medical Service, Department of Veterans Affairs, NJ Health Care System, 385 Tremont Avenue, East Orange, NJ 07018-1095.
    Affiliations
    Medical Service and the Surgical Service, the Department of Veterans Affairs New Jersey Health Care System, East Orange, New Jersey, USA

    New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
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  • Norman H. Ertel
    Affiliations
    Medical Service and the Surgical Service, the Department of Veterans Affairs New Jersey Health Care System, East Orange, New Jersey, USA

    New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
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  • Anne Mosenthal
    Affiliations
    Medical Service and the Surgical Service, the Department of Veterans Affairs New Jersey Health Care System, East Orange, New Jersey, USA

    New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
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  • William Oser
    Affiliations
    Medical Service and the Surgical Service, the Department of Veterans Affairs New Jersey Health Care System, East Orange, New Jersey, USA

    New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
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      Abstract

      In a previous retrospective study, we reported a significant reduction in serum cholesterol levels following major surgery, and speculated on the possible role of cytokines in this reduction. The purpose of this article is to report a prospective study of the association of cytokines with postoperative changes in serum lipoprotein levels. Serum samples were obtained from 11 male patients before and at intervals for up to 10 days after surgery, and were assayed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), cortisol, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interferon-γ (IFN-γ). LDL-C was calculated. The TC showed a 27.9% decrease, from a mean of 4.27 mmol/L to 3.08 mmol/L (p < 0.001) after surgery, reaching a nadir at 24 hours and returning to preoperative values in 7 to 10 days. A similar decrease was noted in the HDL-C and LDL-C levels. IL-6 levels increased from a mean baseline value of 6 pg/ml to a peak of 143 pg/ml at 24 hours (p < 0.0006). There was an inverse relationship between TC and IL-6 levels, with r = −0.51 for the entire curve and r = −0.90 for the cholesterol nadir with the IL-6 peak. The other cytokines did not show significant changes. We conclude that TC and its fractions decrease to a nadir and that IL-6 increases to a peak approximately 24 hours after major surgery. There is a significant inverse correlation between TC and IL-6, suggesting a possible role of IL-6 in postoperative changes in serum lipoproteins.

      Abbreviations:

      ANCVA (analysis of variance), ApoAl (apolipoprotein Al), ApoB (apolipoprotein B), CI (confidence interval), ELISA (enzyme-linked immunosorbent assay), GM-CSF (granulocyte macrophage-colony stimulating factor), HDL-C (high density lipoprotein cholesterol), IFN-γ (interferon-γ), IL-6 (interleukin-6), IL-1β (interleukin-1β), LCAT (lecithin cholesterol acetyltransferase), LDL-C (low density lipoprotein cholesterol), rhlL-3 (recombinant human interleukin-3), rhM-CSF (recombinant human macrophage colony stimulating factor), TC (total cholesterol), TG (triglycerides), TNF-α (tumor necrosis factor-α), T3 (triiodothyronine), TSH (thyroid stimulating hormone)
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