Putative role of endothelial lipase in dialysis patients with hypoalbuminemia and inflammation.
OBJECTIVE
A recent study suggests that inflammation and malnutrition are strongly associated with cardiovascular disease in dialysis patients. Endothelial lipase (EL) is a newly cloned physiological regulator of high-density lipoprotein cholesterol (HDL), which is associated with the progression of atherosclerosis. To clarify the role of EL in dialysis patients, we evaluated serum markers on the basis of the presence of hypoalbuminemia and inflammation.


METHODS
We divided the 97 study patients into two groups on the basis of serum albumin (Alb) and high-sensitive C-reactive protein (hsCRP) levels, and measured serum EL levels. Serum EL levels were significantly correlated with Alb, cholinesterase, log hsCRP, and log tumor necrosis factor-alpha. They were also assigned to one of three groups on the basis of hypoalbuminemia and inflammatory status.


RESULTS
Serum EL levels were significantly higher and serum HDL levels were lower in patients with low serum Alb and/or high hsCRP levels than in those without these abnormalities. Furthermore, when patients were classified into two groups on the basis of the EL levels measured, cardiovascular disease events during the 2-year follow-up period were significantly greater in the group with higher EL levels.


CONCLUSIONS
Our findings suggest that the link between EL, hypoalbuminemia and inflammation may play an important role in atherogenesis in dialysis patients.
Fujii
Hideki
H
Division of Nephrology, Kidney Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Fukuda
Akira
A
Tanaka
Motoko
M
Kojima
Yoko
Y
Ishida
Tatsuro
T
Hirata
Ken-Ichi
K
Fukagawa
Masafumi
M
D000368:Aged; D050197:Atherosclerosis / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications / Q000378:metabolism*; D007249:Inflammation; D008049:Lipase / Q000502:physiology*; D008055:Lipids / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*
D008076:Cholesterol, HDL; D008055:Lipids; C410382:LIPG protein, human; D008049:Lipase