Remnant-Like Particle Cholesterol May Indicate Atherogenic Risk in Patients on Chronic Hemodialysis

Oda, Hiroaki; Yorioka, Noriaki; Okushin, Sayuri; Nishida, Yasuhiro; Kushihata, Shigeyuki; Ito, Takafumi; Yamakido, Michio

doi:10.1159/000190133

Cited by 25 publications

(16 citation statements)

References 21 publications

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“…The low levels of plasma LDL seem to be typical in well-controlled CKD patients on maintenance HD in Japan. Plasma TG-rich lipoprotein remnant levels were high in HD patients, as previously reported [2,3]. Subfractionation of plasma LDL and HDL is usually performed by polyacrylamide gel electrophoresis, however the chemical composition of LDL and HDL subfractions cannot be determined by that method alone.…”

Section: Discussionsupporting

confidence: 64%

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Skew of Plasma Low- and High-Density Lipoprotein Distributions to Less Dense Subfractions in Normotriglyceridemic Chronic Kidney Disease Patients on Maintenance Hemodialysis Treatment

Homma

Shiina

et al. 2013

Nephron Clin Pract

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Background: Plasma levels of small, dense low-density lipoprotein (LDL) were reported to increase in chronic kidney disease (CKD) patients on hemodialysis (HD), but most of these patients were hypertriglyceridemic. Plasma levels of small, dense LDL are known to increase in hypertriglyceridemic subjects. Therefore, to investigate the direct effect of CKD on the distribution of LDL subfractions, we investigated the distribution of LDL subfractions in normotriglyceridemic CKD patients on HD. Methods: The levels of plasma lipoprotein subfractions and lecithin:cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP), which markedly influence the distributions of plasma LDL and high-density lipoprotein (HDL) subfractions, were compared between 40 HD patients and 40 normolipidemic controls. Plasma lipoproteins were subfractionated into seven subfractions by ultracentrifugation. Results: Plasma levels of cholesterol (C) in remnant-like particle, which is equivalent to the triglyceride (TG)-rich lipoprotein remnant, were twice as high in HD patients as those in controls with matched TG levels. Plasma levels of C and TG in VLDL and IDL (intermediate density lipoprotein) were slightly higher in HD patients than in controls. The C/TG ratio of VLDL was significantly higher in HD patients than in controls. In comparison with the corresponding values in controls, the C and TG levels in low-density LDL and HDL₂ in HD patients were high, whereas those in medium-density LDL, high-density LDL, and HDL₃ were low. Plasma LCAT activity and CETP mass were lower in HD patients than in controls. Conclusion: Distribution of LDL and HDL skewed toward less dense fractions in normotriglyceridemic CKD patients on HD. A decrease in reverse C transport likely played an important role in these changes in the patients.

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Section: Discussionsupporting

confidence: 64%

“…Plasma levels of triglyceride (TG)-rich lipoproteins and their remnants are known to be elevated in chronic kidney disease (CKD) patients on hemodialysis (HD) treatment [1,2,3]. Chylomicron and very low-density lipoprotein (VLDL) are TG-rich lipoproteins [4].…”

Section: Introductionmentioning

confidence: 99%

Skew of Plasma Low- and High-Density Lipoprotein Distributions to Less Dense Subfractions in Normotriglyceridemic Chronic Kidney Disease Patients on Maintenance Hemodialysis Treatment

Homma

Shiina

et al. 2013

Nephron Clin Pract

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“…However, in our study, serum RLP.C levels did not show any significant difference between the DM(+) group and DM(-) group. Oda et al [29] reported that serum RLP.C levels showed a positive correlation with serum levels of T.Cho, TG, LDL.Cho and VLDL.Cho in patients on HD. In our study, though serum TG levels in the DM(+) group were significantly higher than that in the DM(-) group, there were no significant differences in serum levels of T.Cho and LDL.Cho between the two groups (table 1).…”

Section: Discussionmentioning

confidence: 98%

The Significance of Atherogenic Indices in Patients on Hemodialysis

et al. 2000

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Atherosclerotic diseases (ASD) are the major cause of mortality and morbidity in patients on hemodialysis (HD). To evaluate the significance and usefulness of atherogenic indices, we examined lipoprotein(a) (Lp(a)), remnant-like particles cholesterol (RLP.C), homocysteine (Hcy), cardiac troponin T (TnT), and ankle-arm blood pressure index (AABI) in 114 patients on HD (male 79, female 35; age 62.1 ± 1.3 years). As a result, serum cardiac TnT and AABI levels in patients with diabetes mellitus (DM) (n = 33) were significantly higher than those in patients without DM (n = 81). In patients with cerebrovascular diseases (CVD), serum levels of both RLP.C and Hcy, and AABI levels were significantly higher than those in patients without CVD. In patients with coronary artery diseases (CAD), serum cardiac TnT and AABI levels were significantly higher than those in patients without CAD. In patients with peripheral vascular diseases (PVD), serum levels of both Hcy and cardiac TnT were significantly higher than those in patients without PVD. Multiple regression analysis did show that the presence of DM, serum Hcy levels and age were independent factors as- sociated with ASD: ASD = –0.348 + 0.426 × DM (scored: 0, absence; 1, presence) + 0.005 × Hcy (nmol/ml) + 0.010 × Age (years) (p < 0.001). In conclusion, the presence of DM and advanced age are major determinants for atherosclerosis. In addition, serum Hcy levels are independent risk factors for atherosclerosis irrespective of the absence of DM.

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“…It has been reported that LDL-cholesterol is a risk factor in cardiovascular disease, especially in Coronary Atherosclerotic (AS) [31,32]. Plasma levels of small, dense low-density lipoprotein (LDL) were reported to be increased in chronic kidney disease patients who undergoing HD [33,34].…”

Section: Discussionmentioning

confidence: 99%

Influence of L-Carnitine Supplementation on Serum Lipid Profile in Hemodialysis Patients: A Systematic Review and Meta-Analysis

Huang

Song²,

Zhang³

et al. 2013

Kidney Blood Press Res

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Background/Aims: An increasing body of evidence demonstrates that L-carnitine plays a pivotal role in lipid metabolism of hemodialysis (HD) patients. However, there are still some reservations about its benefits. Therefore, we performed a meta-analysis to assess the effects of L-carnitine supplementation on lipid profile in HD patients. Methods: Literature search was performed to identify the relevant randomized controlled trials that investigated the effects of L-carnitine on the lipid profile of subjects. Two independent authors used an Excel file to extract data and assess trials quality. The primary effect measure was the difference in means of the final lipid measurements between the intervention and control groups. The meta-analysis was performed with the fixed-effects model or random-effects model according to heterogeneity. Results: Twelve studies with a total of 391 patients met the inclusion criteria. The use of L-carnitine was not associated with a reduction in the total cholesterol (SMD, -0.11; 95% CI, -0.31 to 0.09), HDL-cholesterol (SMD, 0.01; 95% CI, -0.36 to 0.39), VLDL-cholesterol (SMD, 0.54; 95% CI, -0.06 to 1.14), and the serum triglycerides (SMD, -0.12; 95% CI, -0.36 to 0.12). However, L-carnitine can significantly decrease the LDL-cholesterol (SMD, -0.29; 95% CI, -0.53 to -0.06) in HD patients. In a subgroup meta-analysis, a significant LDL-cholesterol-lowering effect of L-carnitine supplementation was observed in intravenous application group, and patients with longer interventional duration and renal diseases. Conclusion: The limited evidence suggests that there was no effect of L-carnitine on serum total cholesterol, HDL-cholesterol, VLDL-cholesterol and serum triglycerides. By contrast, this meta-analysis suggests a promising effect of L-carnitine on LDL-cholesterol. Further large-scale, well-designed randomized controlled trials are urgently needed

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Remnant-Like Particle Cholesterol May Indicate Atherogenic Risk in Patients on Chronic Hemodialysis

Cited by 25 publications

References 21 publications

Skew of Plasma Low- and High-Density Lipoprotein Distributions to Less Dense Subfractions in Normotriglyceridemic Chronic Kidney Disease Patients on Maintenance Hemodialysis Treatment

Skew of Plasma Low- and High-Density Lipoprotein Distributions to Less Dense Subfractions in Normotriglyceridemic Chronic Kidney Disease Patients on Maintenance Hemodialysis Treatment

The Significance of Atherogenic Indices in Patients on Hemodialysis

Influence of L-Carnitine Supplementation on Serum Lipid Profile in Hemodialysis Patients: A Systematic Review and Meta-Analysis

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