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Hypertriglyceridemia: a possible diagnostic marker of disease severity in visceral leishmaniasis

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Abstract

Purpose

Visceral leishmaniasis (VL), a protozoan disease, is 100 % fatal if left untreated. Anemia is common in VL which plays a role in expression of clinically overt VL disease. Laboratory clues are scarce for strengthening clinical suspicion for severity in VL. Hypertriglyceridemia has emerged as a new concept for the diagnosis and prognosis in VL. The present study is aimed at correlating the magnitude of hypertriglyceridemia with the severity in VL.

Materials and methods

A retrospective case–control study was conducted between January 2012 to December 2013 among 124 patients coming for treatment from VL endemic areas, who had fever of more than 15 days and did not respond to antimalarials and antibiotics. The parasitologically confirmed VL cases (n = 87) were categorized as mild/moderate (n = 60) and severe (n = 27) groups according to WHO classification for anemia and parasite burden. Serum triglycerides were assayed in VL groups along with controls (n = 37).

Results

Serum triglyceride level was significantly higher in VL than controls [mean values were 173.50 ± 47.67 versus 127.1 ± 53.79 mg/dl, respectively (p < 0.0001)]. Triglyceride level was significantly higher in severe than in mild/moderate group of VL [211.3 ± 50.2 mg/dl versus 134 ± 45.09 mg/dl, respectively (p < 0.0001)]. Hypertriglyceridemia (>161.7 mg/dl) was noted in all severe VL patients, compared to 31.66 % of mild or moderate group (p < 0.0001). There was no significant difference between mild/moderate VL and controls.

Conclusions

It is hypothesized that hypertriglyceridemia could be of additional diagnostic benefit to assess the probability and severity of VL in endemic areas.

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Acknowledgments

The authors wish to acknowledge Indian Council of Medical Research (Department of Health Research, Ministry of Health and Family Welfare, Govt. of India), New Delhi, for identifying the present work under ‘Translational Research’. The technical work rendered by Mr. Sudarshan Prasad, technician, is also acknowledged.

Funding

This study did not receive any funding from outside agency. The present work was based on intramural studies carried out at our institute.

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    Authors and Affiliations

    1. Division of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India

      C. S. Lal, S. Kumar, R. K. Paswan, A. Kumari & P. Sinha

    2. Division of Social Sciences, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India

      R. B. Verma

    3. Division of Pathology, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India

      N. Verma

    4. Division of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India

      N. A. Siddiqui

    5. Division of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India

      V. N. Rabidas & K. Pandey

    6. Division of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agam-kuan, Patna, 800007, Bihar, India

      D. Singh & P. Das

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    1. C. S. Lal
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    Correspondence to C. S. Lal.

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    The authors declare that they have no conflict of interest.

    Ethical approval

    The data under this retrospective study have been allowed to be taken from intramural studies approved by ethics committee of the institute and conducted in accordance with the 1975 Helsinki Declaration on Human Rights, as revised in Edinburgh 2000.

    Additional information

    C. S. Lal and N. Verma contributed equally and may be considered as joint first author. C.S. Lal and R.B. Verma may be considered as joint corresponding author.

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    Lal, C.S., Verma, R.B., Verma, N. et al. Hypertriglyceridemia: a possible diagnostic marker of disease severity in visceral leishmaniasis. Infection 44, 39–45 (2016). https://doi.org/10.1007/s15010-015-0811-9

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    • DOI: https://doi.org/10.1007/s15010-015-0811-9

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