Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed （HD） and post-renal transplant （Tx） patients are proatherogenic, but elevated concentrations of plasma high-density lipop...Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed （HD） and post-renal transplant （Tx） patients are proatherogenic, but elevated concentrations of plasma high-density lipoprotein （HDL） reduce the risk of cardiovascular disease. We investigated the concentrations of lipid, lipoprotein, HDL particle, oxidized low-density lipoprotein （ox-LDL） and anti-ox-LDL, and paraoxonase-1 （PON-1） activity in HD （n=33） and Tx （n=71） patients who were non-smokers without active inflammatory disease, liver disease, diabetes, or malignancy. HD patients had moderate hypertriglyceridemia, normocholesterolemia, low HDL-C, apolipoprotein A-I （apoA-I） and HDL particle concentrations as well as PON-1 activity, and increased ox-LDL and anti-ox-LDL levels. Tx patients had hypertriglyceridemia, hypercholesterolemia, moderately decreased HDL-C and HDL particle concentrations and PON-1 activity, and moderately increased ox-LDL and anti-ox-LDL levels as compared to the reference, but ox-LDL and anti-ox-LDL levels and PON-1 activity were more disturbed in HD patients. However, in both patient groups, lipid and lipoprotein ratios （total cholesterol （TC）/HDL-C, LDL-C/HDL-C, triglyceride （TG）/HDL-C, HDL-C/non-HDL-C, apoA-I/apoB, HDL-C/apoA-I, TG/HDL） were atherogenic. The Spearman＇s rank coefficient test showed that the concentration of ox-LDL correlated positively with HDL particle level （R=0.363, P=0.004）, and negatively with TC （R=-0.306, P=0.012）, LDL-C （R=-0.283, P=0.020）, and non-HDL-C （R=-0.263, P=0.030） levels in Tx patients. Multiple stepwise forward regression analysis in Tx patients demonstrated that ox-LDL concentration, as an independent variable, was associated significantly positively with HDL particle level. The results indicated that ox-LDL and de- creased PON-1 activity in Tx patients may give rise to more mildly-oxidized HDLs, which are less stable, easily undergo metabolic remodeling, generate a greater number of smaller pre-1展开更多
End stage-renal-disease (ESRD) is associated with dyslipidemia and premature atherosclerosis. The study evaluates the effect of hemodialysis (HD) on HDL-remodeling between pre- and post-HD. Was conducted a cross-secti...End stage-renal-disease (ESRD) is associated with dyslipidemia and premature atherosclerosis. The study evaluates the effect of hemodialysis (HD) on HDL-remodeling between pre- and post-HD. Was conducted a cross-sectional study with 50 ESRD male patients, undergoing HD at Ana Neri Hospital, Salvador, Brazil. All individuals were on HD for at least 3 months, into a three sessions protocol for 3 - 4 hours per week, with a polysulfone low-flow basic-dialyzing-membrane and unfractionated-heparin. HDL Phospholipid-incorporation was measured by 14C-PL-scintillation-counting, expressed as %14C-PL/mL/hour. Paraoxonase (PON-1) activity was measured by spectrophotometry using paraoxon as substrate. Cardiovascular risk ratios and atherogenic index of plasma were calculated. Total cholesterol, HDL-C and non-HDL-C increased at post-HD on all age groups, but without triglycerides (TG) changes. TG/HDL-C decreased in 30 - 39 and 40 - 49 year (y) at post-HD (p 0.05). LDL-C/apoB increased in >60 y, after HD (p < 0.05). HDL-C/apo-AI increased in 40 - 49 y (p 0.05) and >60 (p 0.01). On the other hand, non-HDL-C/HDL-C reduced in 40 - 49 and >60 y, at post-HD (p 0.05). The linear-correlation between %14C-PL-incorporation and non-HDL-C/HDL-C was negative in 30 - 39 y, both at pre-HD (r = -0.90;p = 0.002) and post-HD (r = -0.78;p = 0.022). Linear-correlation between PON-1 and %14C-PL-incorporation was positive in >60 y, both at pre- (r = 0.63;p = 0.029) and post-HD (r = 0.65;p = 0.022). PON-1 activity increased at pre- (59 ± 30) and post-HD (73 ± 38) in 50 - 59 y (p 0.05). The %14C-PL-incorporation was reduced in >60 y (p 0.05), when compared to pre- and post-HD. ESRD patients undergoing HD shows important changes on lipid-profile, PON-1-activity, cardiac risk ratios and HDL-remodeling. These results demonstrate the influence of HD with a polysulfone low-flow basic-dialyzing-membrane and unfractionated-heparin on lipoprotein metabolism.展开更多
基金Project(Nos.PW 55/09 and DS 41/10) supported by the Department of Laboratory Diagnostics,Medical University of Lublin,Poland
文摘Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed （HD） and post-renal transplant （Tx） patients are proatherogenic, but elevated concentrations of plasma high-density lipoprotein （HDL） reduce the risk of cardiovascular disease. We investigated the concentrations of lipid, lipoprotein, HDL particle, oxidized low-density lipoprotein （ox-LDL） and anti-ox-LDL, and paraoxonase-1 （PON-1） activity in HD （n=33） and Tx （n=71） patients who were non-smokers without active inflammatory disease, liver disease, diabetes, or malignancy. HD patients had moderate hypertriglyceridemia, normocholesterolemia, low HDL-C, apolipoprotein A-I （apoA-I） and HDL particle concentrations as well as PON-1 activity, and increased ox-LDL and anti-ox-LDL levels. Tx patients had hypertriglyceridemia, hypercholesterolemia, moderately decreased HDL-C and HDL particle concentrations and PON-1 activity, and moderately increased ox-LDL and anti-ox-LDL levels as compared to the reference, but ox-LDL and anti-ox-LDL levels and PON-1 activity were more disturbed in HD patients. However, in both patient groups, lipid and lipoprotein ratios （total cholesterol （TC）/HDL-C, LDL-C/HDL-C, triglyceride （TG）/HDL-C, HDL-C/non-HDL-C, apoA-I/apoB, HDL-C/apoA-I, TG/HDL） were atherogenic. The Spearman＇s rank coefficient test showed that the concentration of ox-LDL correlated positively with HDL particle level （R=0.363, P=0.004）, and negatively with TC （R=-0.306, P=0.012）, LDL-C （R=-0.283, P=0.020）, and non-HDL-C （R=-0.263, P=0.030） levels in Tx patients. Multiple stepwise forward regression analysis in Tx patients demonstrated that ox-LDL concentration, as an independent variable, was associated significantly positively with HDL particle level. The results indicated that ox-LDL and de- creased PON-1 activity in Tx patients may give rise to more mildly-oxidized HDLs, which are less stable, easily undergo metabolic remodeling, generate a greater number of smaller pre-1
文摘End stage-renal-disease (ESRD) is associated with dyslipidemia and premature atherosclerosis. The study evaluates the effect of hemodialysis (HD) on HDL-remodeling between pre- and post-HD. Was conducted a cross-sectional study with 50 ESRD male patients, undergoing HD at Ana Neri Hospital, Salvador, Brazil. All individuals were on HD for at least 3 months, into a three sessions protocol for 3 - 4 hours per week, with a polysulfone low-flow basic-dialyzing-membrane and unfractionated-heparin. HDL Phospholipid-incorporation was measured by 14C-PL-scintillation-counting, expressed as %14C-PL/mL/hour. Paraoxonase (PON-1) activity was measured by spectrophotometry using paraoxon as substrate. Cardiovascular risk ratios and atherogenic index of plasma were calculated. Total cholesterol, HDL-C and non-HDL-C increased at post-HD on all age groups, but without triglycerides (TG) changes. TG/HDL-C decreased in 30 - 39 and 40 - 49 year (y) at post-HD (p 0.05). LDL-C/apoB increased in >60 y, after HD (p < 0.05). HDL-C/apo-AI increased in 40 - 49 y (p 0.05) and >60 (p 0.01). On the other hand, non-HDL-C/HDL-C reduced in 40 - 49 and >60 y, at post-HD (p 0.05). The linear-correlation between %14C-PL-incorporation and non-HDL-C/HDL-C was negative in 30 - 39 y, both at pre-HD (r = -0.90;p = 0.002) and post-HD (r = -0.78;p = 0.022). Linear-correlation between PON-1 and %14C-PL-incorporation was positive in >60 y, both at pre- (r = 0.63;p = 0.029) and post-HD (r = 0.65;p = 0.022). PON-1 activity increased at pre- (59 ± 30) and post-HD (73 ± 38) in 50 - 59 y (p 0.05). The %14C-PL-incorporation was reduced in >60 y (p 0.05), when compared to pre- and post-HD. ESRD patients undergoing HD shows important changes on lipid-profile, PON-1-activity, cardiac risk ratios and HDL-remodeling. These results demonstrate the influence of HD with a polysulfone low-flow basic-dialyzing-membrane and unfractionated-heparin on lipoprotein metabolism.
