Serum lipids and lipoproteins in malaria - a systematic review and meta-analysis

Malaria Journal

Research

Rosanne W Wieten¹  Benjamin J Visser²  Martin P Grobusch²  Ingeborg M Nagel³ 

[1] Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, PO Box 226601100 DD, Meibergdreef 9, Amsterdam, The Netherlands;Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon;Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, PO Box 226601100 DD, Meibergdreef 9, Amsterdam, The Netherlands;Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon;Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany;Medical Library, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;

关键词: Malaria;    Lipids;    Meta-analysis;    Cholesterol;    Lipoproteins;    High-density lipoprotein (HDL);    Low-density lipoprotein (LDL);    Very low-density lipoprotein (VLDL);    Triglycerides;    Haemozoin (Hz);   

DOI  :  10.1186/1475-2875-12-442

 received in 2013-09-13, accepted in 2013-12-04,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundSerum lipid profile changes have been observed during malaria infection. The underlying biological mechanisms remain unclear. The aim of this paper is to provide an overview on those serum lipid profile changes, and to discuss possible underlying biological mechanisms and the role of lipids in malaria pathogenesis.MethodsA systematic review and meta-analysis to determine lipid profile changes during malaria was conducted, following PRISMA guidelines. Without language restrictions, Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, Biosis Previews and the African Index Medicus were searched for studies published up to 11 July, 2013, that measured serum lipid parameters in malaria patients. Also, major trial registries were searched. Mean differences in lipid profile parameters were combined in fixed and random effects meta-analysis, with a separate analysis for different groups of controls (healthy, other febrile illnesses or very low parasitaemia). These parameters were also compared between severe malaria and uncomplicated malaria. Funnel plots were used to test for publication bias.ResultsOf 2,518 studies reviewed, 42 met the criteria for inclusion in the qualitative analysis, and of these, 15 reported the necessary data for inclusion in the meta-analysis for cholesterol; nine for high-density lipoprotein (HDL), eight for low-density lipoprotein (LDL), and nine for triglycerides, respectively. Total cholesterol, HDL and LDL concentrations were lower in malaria and other febrile diseases compared to healthy controls. The decline was more pronounced and statistically significant during malaria compared to other febrile diseases. These results were consistent across included studies. Triglycerides were raised compared to healthy controls, but not statistically significant when compared to symptomatic controls.ConclusionsThis meta-analysis suggests that the observed lipid profile changes are characteristic for malaria. Although a definite link with the pathogenesis of malaria cannot yet be demonstrated, plausible hypotheses of biological mechanisms involving host lipid alterations and the pathogenesis of malaria exist. An increased research effort to elucidate the precise pathways is warranted, since this could lead to better understanding of malaria pathophysiology and consequently to novel treatment approaches.

【 授权许可】

Unknown   
© Visser et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.