The role of serum HLD, LDL, and uric acid levels in predicting the prognosis of community-acquired pneumonia

Abstract

Purpose: Community-acquired pneumonia (CAP) leads to inflammation and oxidative stress as a result in infection. In the present study, we aimed to investigate the relationship between initial serum high-density lipoprotein (HDL), low-density lipoprotein (HDL), and uric acid levels on short-term (30-day) changes in the course of CAP. Materials and methods: The retrospective study included 113 patients with CAP that received inpatient care between 2012 and 2018.The HDL, LDL and uric acid values in the blood received in hospital admission were examined for their relationship with short-term mortality and correlation with hospitalization. Results: The 113 patients comprised 71 (62.8%) men and 42 (37.2%) women with a mean age of 74±11 years. Of the 113 patients, 30-day mortality occurred in 12 (10.6%) patients. Of the 113 patients, 17 (16.5%) patients were hospitalized in ICU. All cases detected as mortality were followed in ICU. Normal ranges of HDL, LDL, and uric acid concentrations were accepted as 40-70 mg/dL, 60-130 mg/dL, and 1.8-8 mg/dL, respectively. The mean serum LDL, HDL, and uric acid levels were 97.95±42.11 (range, 26-271) mg/dL, 40.94±13.70 (range, 5.10-83.20) mg/dL, and 5.99±2.18 (range, 1.40-13.20) mg/dL, respectively. HDL and LDL levels were found to be insignificant predictors of 30-day mortality ( p =0.482 and p =0.725, respectively). Similarly, serum HDL, LDL, and uric acid levels were found to be insignificant predictors of the duration of hospitalization and ICU requirement. On the other hand, multivariate logistic regression analysis indicated that uric acid concentration was a protective factor for 30-day mortality (OR, 0.694; 95% Cl, 0.478-0.989, p =0.048), whereby increased uric acid concentration was found to decrease the risk of mortality and reduced uric acid concentration was found to increase the risk of mortality by 1.44 times (1/0.694). Conclusion: We suggest that monitoring uric acid levels with serial measurements in patients with CAP may be useful for predicting the short term prognosis. Further prospective multicentric studies with larger patient series are needed to investigate the correlation between serum uric acid levels and clinical risk scores.