Serum Lipids and Lipoproteins During Uncomplicated Malaria: A Cohort Study in Lambaréné, Gabon

Abstract

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 . 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.[

Lipid profiles among Plasmodium falciparum infected, non malarial febrile patients and volunteers

“…Benjamin J et al in their study found that serum lipid levels (mmol/l) were significantly lower in malaria patients compared with those with other febrile diseases. 9 In present study mean value for total cholesterol was significantly lower in pf .malaria (151±12.83mg/dl) than in control group (182.64±12.08mg/dl) P-Value <0.05. Similarly serum HDL is significantly lower in pf malaria 29.39±5.66 mg/dl than in control group 40.4±3.29 mg/dl (P <0.05).…”

“…Benjamin J et al found that these result were consistent across their studies. 9 TG were raised in complicated than in healthy controls, but not statistically significant when compared to symptomatic control. As there was no significant difference in serum lipid between in healthy volunteers and non malarial febrile controls it is postulated that the changes in lipid profile in pf.…”

“…10 Present study along with study of Benjamin et al does not agree with this finding. 9 Visser et al in his Meta analysis, total cholesterol, HDL and LDL concentration were lower in malaria and other febrile illness compared to healthy controls. 11 TG were raised compared to healthy controls but not statistically significant when compared to symptomatic control.…”

Sida acuta Burm.f. leaves ethanol extract ameliorates haematological and biochemical alterations induced by Plasmodium berghei ANKA-65 in mice

“…It was also reported that the extent of dyslipidemia is dependent on the severity of the disease [9,10]. Similar studies in both vivax and falciparum malaria patients reported that concentrations of HDL, LDL, and CHOL decreased significantly but TAGs increased in malaria-infected patients than in healthy control [11][12][13][14][15]. These reports generally support the opinion that malaria induces dyslipidaemia and hence, a good antimalarial agent should, in addition to clearing malaria parasite, restore homeostasis in lipid status.…”

Real-time cholesterol sorting in Plasmodium falciparum-erythrocytes as revealed by 3D label-free imaging

“…These changes alter the erythrocyte's surface structure and contribute to the clinical manifestations of the disease [4][5][6][7] . Furthermore, people who become infected with P. falciparum parasites commonly develop decreased blood levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL) and cholesterol 8,9 . Such alterations in blood constituents suggest that P. falciparum may use various lipid components in the blood, including lipoproteins, for its survival.…”