{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:40:51Z","timestamp":1792464051774,"version":"4.5.0"},"reference-count":0,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low circulating cholesterol is a recognised feature of sepsis, but whether the serum lipid signature of sepsis differs from that of sterile (non-infectious) inflammation is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Targeted serum proton nuclear magnetic resonance (NMR) metabolomics (250 metabolites) was used to compare 34 patients with sepsis, 21 patients before and after major elective surgery, and 89 healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with healthy controls, 199 metabolites differed in sepsis and 150 after surgery. 127 changes were common to both states, 23 specific to surgery and 72 to sepsis. Both states lowered total, LDL and HDL cholesterol, cholesteryl esters, phospholipids and several fatty acids. Surgery alone reduced apolipoprotein B, remnant cholesterol and LDL particle number, whereas triglyceride-rich VLDL and the inflammatory marker GlycA were higher in sepsis only. Triglyceride-rich lipoproteins fell after surgery but rose in sepsis, and the sepsis-specific signature was dominated by a coordinated rise across the VLDL subclasses with a fall across the large HDL subclasses. No metabolite distinguished sepsis survivors from non-survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low cholesterol was common to both post-operative and septic states, whereas a rise in triglyceride-rich VLDL was detected in sepsis but not after surgery. These exploratory differences require confirmation in matched cohorts, and illustrate how lipid-focused NMR spectroscopy can provide a detailed analysis of cholesterol and lipoprotein signatures in critical illness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13054-026-06401-2","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:34:33Z","timestamp":1792463673000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct serum cholesterol and lipoprotein signatures in sepsis and major elective surgery: a lipid-focused NMR study"],"prefix":"10.1186","author":[{"given":"Antoine","family":"Villa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra E.","family":"Oppong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica J.","family":"Manson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kleyman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Brealey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervyn","family":"Singer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth C.","family":"Jury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishkantha","family":"Arulkumaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,20]]},"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13054-026-06401-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:34:34Z","timestamp":1792463674000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13054-026-06401-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":0,"alternative-id":["6401"],"URL":"https:\/\/doi.org\/10.1186\/s13054-026-06401-2","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"assertion":[{"value":"14 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The healthy-control serum was obtained under the research ethics approvals reported by Oppong et al. (iScience 2024; University College London Hospitals NHS Foundation Trust Research Ethics Committee), with written informed consent. Patients with sepsis and surgical patients were recruited into the Calprotectin in Infections and Sepsis study, approved by the London\u2013Queen Square Research Ethics Committee (20\/LO\/1024; IRAS 266594); written informed consent, or consultee agreement where a patient lacked capacity, was obtained. All samples were collected in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}