ASSOCIATION OF LDL CHOLESTEROL AND ALKALINE PHOSPHATASE TO-ALBUMIN RATIO WITH CLINICAL OUTCOMES IN SEPSIS PATIENTS ADMITTED TO INTENSIVE CARE UNIT: A PROSPECTIVE OBSERVATIONAL STUDY
Authors: Huda Muhammadi, Aiyappa DS, Shobharani S, Akshay HM*, Nagashree V, Taniya Erum
Publication Date: 2026/03/25
DOI: 10.59551/DOI: 10.59551/IJHMP/25832069/2026.7.1.102
Abstract
<p>Background: Sepsis is a life-threatening condition characterized by a dysregulated host response to infection and is a major cause of mortality among critically ill patients in intensive care units (ICUs). Identifying reliable prognostic biomarkers is important for improving early risk stratification and clinical outcomes. Emerging evidence suggests that alterations in lipid metabolism and inflammatory markers, including low-density lipoprotein cholesterol (LDL-C) and the alkaline phosphatase-to-albumin ratio (APAR), may play a role in sepsis prognosis.</p>
<p>Methods: A prospective observational study was conducted among 51 adult patients diagnosed with sepsis or septic shock admitted to the ICU at JSS Hospital, Mysuru, India. Clinical, demographic, and laboratory data were collected within 24 hours of ICU admission. LDL-C levels were obtained from lipid profile analysis, and APAR was calculated using alkaline phosphatase and albumin levels. Statistical analysis was performed using JASP software (Version 0.95.4). Comparisons between survivors and non-survivors were conducted, and correlation as well as multivariate logistic regression analyses were performed to evaluate predictors of mortality.</p>
<p>Results: Among the 51 patients included in the study, 40 survived and 11 were non-survivors. LDL-C levels were lower in non-survivors compared to survivors (34.27 ± 26.89 vs 50.05 ± 28.18 mg/dL), while APAR values were higher among non-survivors (114.05 ± 204.49 vs 58.66 ± 45.59). However, these differences were not statistically significant. LDL-C demonstrated a significant negative correlation with procalcitonin levels (r = −0.288, p = 0.045). Multivariate logistic regression analysis showed that LDL-C, APAR, APACHE score, and albumin were not independent predictors of mortality.</p>
<p>Conclusion: Although lower LDL-C levels and higher APAR values were observed among non-survivors, these biomarkers were not independently associated with mortality in ICU patients with sepsis. Further large-scale multicenter studies are required to clarify the prognostic value of LDL-C and APAR in critically ill sepsis patients.</p>
<p>KEYWORDS: Sepsis, ICU Mortality, LDL Cholesterol, Alkaline Phosphatase-to-Albumin Ratio, APAR, Prognostic Biomarkers, Critical Care.</p>
References
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