scholarly journals The Protective Role of Adiponectin for Lipoproteins in End-Stage Renal Disease Patients: Relationship with Diabetes and Body Mass Index

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Susana Coimbra ◽  
Flávio Reis ◽  
Sara Nunes ◽  
Sofia Viana ◽  
Maria João Valente ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Obese Patients ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Cardiovascular disease (CVD) events are the main causes of death in end-stage renal disease (ESRD) patients on dialysis. The number and severity of CVD events remain inappropriate and difficult to explain by considering only the classic CVD risk factors. Our aim was to clarify the changes and the relationship of lipoprotein subfractions with other CVD risk factors, namely, body mass index (BMI) and adipokines, inflammation and low-density lipoprotein (LDL) oxidation, and the burden of the most prevalent comorbidities, diabetes mellitus (DM) and hypertension (HT). We studied 194 ESRD patients on dialysis and 22 controls; lipid profile, including lipoprotein subpopulations and oxidized LDL (oxLDL), C-reactive protein (CRP), adiponectin, leptin, and paraoxonase 1 activity were evaluated. Compared to controls, patients presented significantly lower levels of cholesterol, high-density lipoprotein cholesterol (HDLc), LDLc, oxLDL, and intermediate and small HDL and higher triglycerides, CRP, adiponectin, large HDL, very-low-density lipoprotein (VLDL), and intermediate-density lipoprotein- (IDL) B. Adiponectin levels correlated positively with large HDL and negatively with intermediate and small HDL, oxLDL/LDLc, and BMI; patients with DM (n=17) and with DM+HT (n=70), as compared to patients without DM or HT (n=69) or only with HT (n=38), presented significantly higher oxLDL, oxLDL/LDLc, and leptin and lower adiponectin. Obese patients (n=45), as compared to normoponderal patients (n=81), showed lower HDLc, adiponectin, and large HDL and significantly higher leptin, VLDL, and intermediate and small HDL. In ESRD, the higher adiponectin seems to favor atheroprotective HDL modifications and protect LDL particles from oxidative atherogenic changes. However, in diabetic and obese patients, adiponectin presents the lowest values, oxLDL/LDLc present the highest ones, and the HDL profile is the more atherogenic. Our data suggest that the coexistence of DM and adiposity in ESRD patients on dialysis contributes to a higher CVD risk, as showed by their lipid and adipokine profiles.

scholarly journals Antibody to oxidized low-density lipoprotein and cardiovascular mortality in end-stage renal disease

2002 ◽  
Vol 62 (6) ◽  
pp. 2230-2237 ◽  
Author(s):  
Tetsuo Shoji ◽  
Mariko Fukumoto ◽  
Eiji Kimoto ◽  
Kayo Shinohara ◽  
Masanori Emoto ◽  
...  
Keyword(s):  
Renal Disease ◽  
Cardiovascular Mortality ◽  
End Stage Renal Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Oxidized Low Density Lipoprotein ◽  
Stage Renal Disease ◽  
End Stage

P1581IMPACT OF ACHIEVING LDL CHOLESTEROL LOWER THAN 100 MG/DL WITH STATINS, ON LIPID PROFILE AND INFLAMMATION IN END-STAGE RENAL DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Susana Coimbra ◽  
Flávio Reis ◽  
Sara Nunes ◽  
Sofia D. Viana ◽  
Maria João Valente ◽  
...  
Keyword(s):  
Lipid Profile ◽  
End Stage Renal Disease ◽  
Inflammatory Markers ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Group 2 ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Group 1

Abstract Background and Aims Dyslipidemia is common in chronic kidney disease (CKD) and cardiovascular disease (CVD)-related events are the main causes of death in end-stage renal disease (ESRD) patients on dialysis. Concerning lipid management, clinical practice emphasized treatment escalation to achieve specific low-density lipoprotein cholesterol (LDLc) targets, which implies repeated LDLc evaluations, and enhancement of statin doses or combination of lipid-lowering therapies. However, the LDLc target is not consensual, with some entities suggesting 100 mg/dl and others a more conservative level. It has been hypothesized that lipoprotein’s quality (size, composition and functionality) may be more important than their total circulating levels, as CVD risk factor. Our aim was to evaluate and compare, in ESRD patients on dialysis and under statins treatment, the levels of lipoprotein fractions and subfractions and inflammatory markers, between patients who achieved LDLc levels < 100 mg/dl and those who did not achieve that target. Method We studied 110 ESRD patients on dialysis (high-flux hemodialysis or hemodiafiltration) and under statin therapy; 87 presented a LDLc < 100 mg/dl (group 1) and 23 a value > 100 mg/dl (group 2); levels of high-sensitivity C-reactive protein (hsCRP), interleukin(IL)-6, lipid profile including lipoprotein fractions/subfractions, and oxidized LDL (oxLDL) were evaluated. Results Group 1, as compared to group 2, presented lower values of total cholesterol (TC), triglycerides, oxLDL, TC/high-density lipoprotein cholesterol (HDLc) and LDLc/HDLc ratios. Concerning lipoprotein fractions/subfractions, group 1 presented significantly higher larger and intermediate LDL, and a trend towards lower small LDL (P=0.063), higher large HDL (P=0.069) and lower small HDL (P=0.080); no significant alterations were found for very-low-density lipoprotein and intermediate-density lipoprotein. Regarding inflammatory markers, no significant differences were observed between the 2 groups. Conclusion Patients who achieved the LDLc < 100 mg/dl target presented a better non-conventional lipid profile, including lower oxLDL levels and an increase in larger (less atherogenic) LDL subfractions. According to our data, a lower LDLc level associates with a better lipid profile; the benefits of this improvement on HDL fractions and CVD-related events in ESRD patients on dialysis needs to be better clarified.

scholarly journals Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Neda Milinković ◽  
Marija Sarić ◽  
Snežana Jovičić ◽  
Duško Mirković ◽  
Višnja Ležaić ◽  
...  
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Density Lipoprotein ◽  
Dialysis Patients ◽  
25 Hydroxy Vitamin D ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Lipid Parameters

SummaryBackgroundSome observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients.MethodsWe have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio.ResultsESRD patients with adjusted 25(OH)D concentrations of ≤ 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDL-C (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of ≤ 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L.ConclusionsOur study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.

P0764STUDY OF 15 CASES OF CHOLESTEROL CRYSTAL EMBOLISM WITH LOW-DENSITY LIPOPROTEIN APHERESIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Taisuke Shimizu ◽  
Tatsuro Sano ◽  
Kaori Takayanagi ◽  
Kouki Ogawa ◽  
Takatsugu Iwashita ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Japanese Patients ◽  
Low Density ◽  
Cholesterol Crystal ◽  
Lipoprotein Apheresis ◽  
Cholesterol Crystal Embolism ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Cholesterol crystal embolism (CCE) causes renal damage, and there is a high risk of end-stage renal disease. Corticosteroids, statins and low-density lipoprotein apheresis (LDL-A) have been used to treat CCE, but the prognosis remains poor and treatment not yet established. This study evaluated the efficacy of LDL-A in patients with CCE. Method We performed a retorospective study of 15 Japanese patients in clinical and histological diagnosis of CCE was made April 2015 to December 2017. 10(67%) patients were diagnosed pathologically on skin biopsy and others were diagnosed clinically. All patients had shown CKD with eGFR &lt;60 mL/min/1.73m2 before being diagnosed with CCE. All patients received LDL-A; of these, 13 (87%) also received corticosteroids. The median estimated GFR diagnosis (at baseline) were 13.4 mL/min/1.73m2, and were analyzed stratified into High eGFR group(H) and Low eGFR group(L). Differences in eGFR, 1 month, 3 months and 1 year after LDL-A, were compared in these groups. Results High eGFR group was significantly higher than Low eGFR group over all observation periods (at 1 month; H:21.3 ± 8.9 vs L:15.9 ± 5.6, P=0.023, at 3 months; H:25.9 ± 10.3 vs L:15.4 ± 5.4, P=0.035, at 1 year; H:21.7 ± 8.9 vs L:13.2 ± 5.7, P=0.01). In high eGFR group, eGFR was no change during the observation period and no decrease significantly. In Low eGFR group, eGFR increased significantly at 1 month and 3 months compared to baseline (10.5 ± 2.1 at baseline, 15.9 ± 5.6 at 1month, P=0.007, 15.4 ± 5.4 at 3month, P=0.01), but was comparable to baseline at 1 year. Conclusion In this study, introduction of LDL-A may have the effect of maintaining renal function over the long term at 1year regardless of eGFR at diagnosed as CCE.

scholarly journals Combined Associations of Serum Ferritin and Body Size Phenotypes With Cardiovascular Risk Profiles: A Chinese Population-Based Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Bowen Zhou ◽  
Siyue Liu ◽  
Gang Yuan
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Body Size ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Cvd Risk Factors ◽  
Cvd Risk

Background: Serum ferritin (SF) has been correlated with one or more metabolic syndrome features associated with an increased risk for cardiovascular disease (CVD). This study explored the associations between SF and CVD risk factors among different body size phenotypes that were based on metabolic status and body mass index (BMI) categories.Methods: A cross-sectional study was performed using a cohort of 7,549 Chinese adults from the China Health and Nutrition Survey. Participants did not exhibit acute inflammation, were not underweight and were stratified based on their metabolic status and BMI categories. The metabolically at-risk status was defined as having two or more criteria of the Adult Treatment Panel-III metabolic syndrome definition, excluding waist circumference.Results: Compared with individuals without high SF, subjects with high SF had an increased risk of diabetes in the metabolically at-risk normal-weight (MANW) and metabolically at-risk overweight/obesity (MAO) groups. The multivariate-adjusted odds ratios (ORs) were 1.52 [95% confidence interval (Cls): 1.02, 2.28] and 1.63 (95% Cls: 1.27, 2.09), respectively. Adjusted ORs for hyperuricemia from high SF in metabolically healthy normal-weight (MHNW), metabolically healthy overweight/obesity (MHO), MANW, and MAO phenotypes were 1.78 (95% Cls: 1.26, 2.53), 1.42 (95% Cls: 1.03, 1.95), 1.66 (95% Cls: 1.17, 2.36), and 1.42 (95% Cls: 1.17, 1.73), respectively. Similarly, positive correlations of high SF with triglycerides, non-high-density lipoprotein cholesterol, and apolipoprotein B100 were observed in all phenotypes. No association between high SF and elevated low-density lipoprotein cholesterol were observed among participants who were metabolically at-risk, regardless of their BMI categories. However, the ORs for elevated low-density lipoprotein cholesterol from high SF were 1.64 (95% Cls: 1.29, 2.08) in the MHNW group and 1.52 (95% Cls:1.22, 1.91) in the MHO group, significantly. This study demonstrated that the highest ORs were in MAO with a high SF group for all unfavorable CVD risk factors except low-density lipoprotein cholesterol (all p &lt; 0.001).Conclusions: The associations of high SF with the prevalence of CVD risk factors, including diabetes, dyslipidemia, and hyperuricemia, vary in individuals among different body size phenotypes. In the MAO group, subjects with high SF levels exhibited worse CVD risk profiles than individuals without high SF.

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