The acute phase reactions, associated with injury, inflammation, or sepsis, markedly affect the concentration and composition of plasma lipids and lipoproteins. Hepatic production of triglycerides and very low density lipoprotein formation are increased, but do not necessarily result in high plasma triglyceride levels. In contrast, all conditions lower plasma cholesterol by decreasing its content in both low-density and high-density lipoproteins. In addition, substantial changes in protein and lipid composition of lipoproteins are observed that may redefine the function of these particles, but also increase their atherogenic and inflammatory properties.