Serum Apolipoprotein-A1 and cholesterol levels in Nigerian children with Plasmodium falciparum infection

Objective: This study was carried out to determine whether or not Plasmodium falciparum malaria infection significantly affected apolipoprotein-A1 and cholesterol levels and if apolipoprotein-A1 correlated with the malaria severity in children younger than 5 years old

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Subjects and Methods: Two hundred and fifty-five children, 170 of whom had microscopically confirmed P. falciparum infection, i.e. 85 cases of uncomplicated malaria [UM] and 85 of complicated malaria [CM], and 85 healthy controls were enrolled in this study. Serum levels of apolipoprotein-A1, total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL] and triglycerides were determined. These levels were compared among the malaria and control groups, using ANOVA and post hoc analyses at p = 0.05

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Results: There were significant differences in the mean serum levels of apolipoprotein-A1 [UM: 104.5 +/- 38.1 mg/dl, CM: 90.9 +/- 33.3 mg/dl and controls: 129.7 +/- 48.3 mg/dl; p < 0.001], total cholesterol [UM: 138.8 +/- 62.9 mg/dl, CM: 121.2 +/- 55.2 mg/dl and controls: 155.1 +/- 69.8 mg/dl; p = 0.002] and LDL [UM: 98.2 +/- 55.5 mg/dl, CM: 84.3 +/- 47.4 mg/dl and controls: 122.7 +/- 69.4 mg/dl; p < 0.001]. Post hoc analyses revealed that children with UM and CM had significantly lower levels of apolipoprotein-A1, cholesterol, HDL and LDL than controls but that there was no difference between the 2 malaria groups. Reductions in levels of lipids and apolipoprotein-A1 were worse in CM than in UM

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Conclusion: Altered levels of serum lipids with CM were associated with a reduction in apolipoprotein-A1. These findings have potential diagnostic utility for the management of malaria