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Objective: To investigate whether circulating high density lipoprotein (HDL) concentrations influence inflammatory cytokine release during abdominal operations. Setting: University Hospital, Japan. Patients: 30 patients who underwent curative operations for gastric cancer. Main outcome measures: Serum HDL and cytokine concentrations were measured preoperatively, and portal and systemic blood samples were taken for the analysis of cytokine and endotoxin concentrations during operations. Results: Portal blood interleukin-6 (IL-6) values of patients with low serum HDL concentrations (n = 6) (< 0.9 mmol/L) were significantly (p < 0.01) higher than those in patients with normal or high HDL concentrations (n = 24) (≥ 0.9 mmol/L) (80.63 (74.62) pg/ml (mean (SD)) compared with 10.25 (9.61) pg/ml.). Moreover, an inverse correlation (r =-0.43, p < 0.05) was found between portal blood IL-6 concentrations and circulating HDL concentrations. Conclusions: We suggest that serum HDL concentrations influence IL-6 release in response to abdominal operations. Circulating HDL particles may reduce endotoxin-induced IL-6 release in humans. [ABSTRACT FROM AUTHOR]