Serum levels of lipoprotein(a) and homocysteine in patients on hemodialysis who take hydroxymethylglutaryl-CoA reductase inhibitors, vitamin B6, and folic acid.
BACKGROUND
High serum levels of lipoprotein(a) and homocysteine are risk factors of cardiovascular disease which are prevalent in patients on hemodialysis. Controversy exists about the effects of hydroxymethylglutaryl-CoA reductase inhibitors on serum lipoprotein(a) levels in patients on hemodialysis. Also, deficiency of some water soluble vitamins and administration of statins may raise serum levels of homocysteine in these patients. This study was designed to investigate serum levels of lipoprotein(a) and homocysteine in patients on hemodialysis who were taking a statin, vitamin B6, and folic acid.


METHODS
We investigated on 152 patients with maintenance hemodialysis who were taking atorvastatin or lovastatin, vitamin B6, and folic acid for at least 6 months. Their serum levels were obtained to measure lipoprotein(a) and homocysteine levels, as well as triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol.


RESULTS
The mean serum values of total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol and triglyceride were significantly less than the maximum reference values (P < .001). The mean serum level of lipoprotein(a) was also less than the reference value (P = .009), but homocysteine level was 33% higher on average than the reference value (P < .001).


CONCLUSIONS
Our study demonstrated that in our patients on hemodialysis, the mean serum level of homocysteine was about 30% higher than the reference value although they were receiving vitamin B6 and folic acid. Hence, they were still exposed to the risk of cardiovascular disease.
Shojaei
Mir Hatef
MH
Department of Nutrition and Biochemistry, Tehran University of Medical Sciences, Tehran, Iran. info@ijkd.org
Djalali
Mamhmoud
M
Siassi
Fereydoun
F
Khatami
Mohammad Reza
MR
Boroumand
Mohammad Ali
MA
Eshragian
Mohammad Reza
MR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism; D003430:Cross-Sectional Studies; D004435:Eating; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D017270:Lipoprotein(a) / Q000097:blood*; D008148:Lovastatin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012307:Risk Factors; D025101:Vitamin B 6 / Q000627:therapeutic use; D014803:Vitamin B Complex / Q000627:therapeutic use*; D055815:Young Adult
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017270:Lipoprotein(a); D011758:Pyrroles; D006710:Homocysteine; D014803:Vitamin B Complex; D025101:Vitamin B 6; D005492:Folic Acid; D008148:Lovastatin; D000069059:Atorvastatin