title: Assessment of myeloperoxidase and oxidative alpha1-antitrypsin in patients on hemodialysis.
abstract: OBJECTIVE
  The present study assesses the effects of the oxidative stress marker, myeloperoxidase (MPO), and the possible MPO-related oxidative stress marker, oxidative alpha(1)-antitrypsin (oxAT), on carotid intima-media thickness (CIMT) and protein-energy wasting (PEW) in patients on hemodialysis (HD).
  
  
  METHODS
  Blood samples were obtained from 383 patients before HD to measure WBC count, serum albumin, lipids, high-sensitivity C-reactive protein (CRP), alpha(1)-antitrypsin (AT), interleukin-6, oxidative LDL-C, MPO, and oxAT. We assessed both CIMT and the geriatric nutritional risk index (GNRI) in this cross-sectional competitive study.
  
  
  RESULTS
  Levels of MPO and oxAT correlated. Myeloperoxidase was associated with max-CIMT, and oxAT correlated with max-CIMT and GNRI. Multivariate linear regression models showed that MPO and oxAT were independent predictors of increasing max-CIMT, whereas oxAT, but not MPO, independently correlated with GNRI. In four combined MPO and oxAT groups classified according to median values, a multinomial logistic regression model showed that high MPO together with high oxAT was independently associated with increased max-CIMT. Moreover, the OR for max-CIMT with positive PEW and high MPO was significantly increased in the four groups with combined MPO and PEW.
  
  
  CONCLUSIONS
  High MPO with high oxAT and high MPO with PEW seem to contribute to plaque formation in patients on HD, whereas elevated MPO or oxAT alone might not predict increasing CIMT. In contrast, a high oxAT value seems to be an independent predictor of PEW in patients on HD.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan. hondah@med.showa-u.ac.jp
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Honda
authors.forename: Masashi
authors.initials: M
authors.lastname: Ueda
authors.forename: Shiho
authors.initials: S
authors.lastname: Kojima
authors.forename: Shinichi
authors.initials: S
authors.lastname: Mashiba
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hirai
authors.forename: Nozomu
authors.initials: N
authors.lastname: Hosaka
authors.forename: Hiroki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Masanori
authors.initials: M
authors.lastname: Mukai
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Keiko
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kanji
authors.initials: K
authors.lastname: Shishido
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018384:Oxidative Stress; D009195:Peroxidase / Q000097:blood*; D011237:Predictive Value of Tests; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000209:etiology*; D006435:Renal Dialysis; D018570:Risk Assessment; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D015854:Up-Regulation; D000515:alpha 1-Antitrypsin / Q000097:blood*
chemical_list: D015415:Biomarkers; C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D009195:Peroxidase