Evolution of triglyceride and total cholesterol levels after critical illness: Preliminary insights into post-ICU...

Dyslipidemia is frequent during critical illness, but its post-ICU evolution remains poorly characterized. This study evaluated changes in total cholesterol and triglyceride levels three months (M3) after ICU discharge.

We retrospectively analyzed a prospective cohort of ICU survivors who attended the M3 post-ICU consultation, with available measurements of total cholesterol, triglycerides, and C-reactive protein (CRP) blood levels. M3 lipid levels were compared to those obtained during the first ICU week and, when available, within three months before ICU admission. Hypertriglyceridemia (HTG) and hypocholesterolemia were defined as triglycerides >210 mg/dL (non-fasting) and total cholesterol ≤120 mg/dL, respectively.

Among 188 patients, HTG was present in 42 (22.3%) at M3, with median triglycerides of 250 [223-329] mg/dL. In 69% of these patients, HTG occurred de novo. HTG was unrelated to diabetes, BMI, or ICU exposures, and correlated weakly with CRP (rs = 0.15, p = 0.025). Hypocholesterolemia was observed in 23 (12.2%) patients, mostly under lipid-lowering therapy. No significant associations were found between lipid abnormalities and muscle strength or readmissions. In a subgroup of 49 patients with pre-admission blood measurements, total cholesterol was higher at M3 than during or before ICU (p < 0.0001), while triglycerides were higher at M3 than before ICU admission (p = 0.019).

Three months after ICU discharge, lipid recovery in survivors appears incomplete. While total cholesterol levels tend to normalize, HTG emerges in approximately 20% of the patients as an underrecognized metabolic sequela of critical illness.