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Characteristics and outcomes of hospitalized older patients who develop hypocholesterolemia
M A Noel1, T K Smith, W H Ettinger
1Department of Internal Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
Objectives:
This research project was undertaken to determine the clinical characteristics, lipoprotein abnormalities, and outcomes of older hospitalized patients who develop hypocholesterolemia.
Methods:
The project had two parts: (1) a retrospective, case-control study of 50 hospitalized patients greater than or equal to 65 years old whose serum cholesterol was normal on admission (greater than or equal to 160 mg/dL) and fell to less than or equal to 120 mg/dL during hospitalization; (2) a laboratory study of lipoproteins in 17 hospitalized patients greater than or equal to 65 years old whose cholesterol was normal on admission but fell to less than or equal to 120 mg/dL during hospitalization.
Results:
Case-control Study--Nine percent of patients greater than or equal to 65 years old developed hypocholesterolemia while in the hospital, and these patients were more likely than controls to have undergone surgery and to have nothing by mouth for 5 days or longer. Cases had a longer length of stay, more complications, and were slightly more likely to die in the hospital than controls. LABORATORY STUDY--Hypocholesterolemic patients had low concentrations of all lipoproteins (VLDL, LDL, HDL), and the LDL and HDL were enriched in triglyceride and depleted of cholesterol ester.
Conclusion:
Acquired hypocholesterolemia is a common finding in hospitalized older patients and is associated with poor outcomes. Patients who became hypocholesterolemic in the hospital had both a low concentration of lipoprotein particles and abnormalities in lipoprotein particle composition.