Assessment of myeloperoxidase and oxidative alpha1-antitrypsin in patients on hemodialysis.
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.
Honda
Hirokazu
H
Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan. hondah@med.showa-u.ac.jp
Ueda
Masashi
M
Kojima
Shiho
S
Mashiba
Shinichi
S
Hirai
Yuki
Y
Hosaka
Nozomu
N
Suzuki
Hiroki
H
Mukai
Masanori
M
Watanabe
Makoto
M
Takahashi
Keiko
K
Shishido
Kanji
K
Akizawa
Tadao
T
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*
D015415:Biomarkers; C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D009195:Peroxidase