Antibody to oxidized low-density lipoprotein and cardiovascular mortality in end-stage renal disease.
BACKGROUND
Immune response to oxidized low-density lipoprotein (oxLDL) may modulate the process of atherogenesis and cardiovascular disease.


METHODS
We performed a prospective, observational cohort study in 249 patients with end-stage renal disease (ESRD) to examine whether the serum titer of anti-oxLDL antibody can predict cardiovascular mortality.


RESULTS
The median anti-oxLDL antibody titer was 320 mU/mL at baseline. During the follow-up (63 +/- 23 months), 72 deaths including 34 cardiovascular deaths occurred. When the subjects were divided into two groups by the median titer, the high titer group showed a lower risk for cardiovascular mortality (P = 0.040 by Kaplan-Meier analysis and log-rank test). Multivariate Cox proportional hazards model indicated that the lower risk of cardiovascular death in the high titer group remained significant (hazard ratio of 0.46, 95%CI 0.23-0.95, P = 0.037) and independent of age, presence of vascular complications, presence of diabetes mellitus, and elevated C-reactive protein. In contrast, anti-oxLDL antibody titer was not associated with non-cardiovascular mortality.


CONCLUSIONS
These results demonstrate, to our knowledge for the first time, that serum anti-oxLDL antibody titer is an independent predictor of cardiovascular mortality in a cohort of patients with ESRD.
Shoji
Tetsuo
T
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. t.shoji@med.osaka-cu.ac.jp
Fukumoto
Mariko
M
Kimoto
Eiji
E
Shinohara
Kayo
K
Emoto
Masanori
M
Tahara
Hideki
H
Koyama
Hidenori
H
Ishimura
Eiji
E
Nakatani
Tatsuya
T
Miki
Takami
T
Tsujimoto
Yoshihiro
Y
Tabata
Tsutomu
T
Nishizawa
Yoshiki
Y
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000276:immunology* / Q000401:mortality; D006973:Hypertension / Q000276:immunology* / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000401:mortality; D008077:Lipoproteins, LDL / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
D001323:Autoantibodies; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein