Oxidized high-density lipoprotein is associated with protein-energy wasting in maintenance hemodialysis patients.
OBJECTIVE
Oxidized HDL (oxHDL) may behave as proinflammatory HDL because of reduced anti-inflammatory capacity and is considered a risk factor for mortality in patients on maintenance hemodialysis (MHD). The study presented here assessed the effect of oxHDL on protein-energy wasting (PEW) in MHD patients.


METHODS
This prospective study examined a cohort of MHD patients (n = 176) who were not taking lipid-lowering drugs. Blood samples were obtained to measure albumin, lipids, high-sensitivity C-reactive protein (hsCRP), oxidized LDL (oxLDL), and oxHDL. PEW was assessed by subjective global assessment (SGA) and geriatric nutritional risk index (GNRI). Measurements and assessment of nutritional status were followed up 1 year later.


RESULTS
OxHDL was significantly increased in patients with PEW at baseline. High oxHDL and high hsCRP were significantly associated with PEW, and receiver operating characteristic curves for oxHDL and hsCRP showed statistically similar accuracy for predicting SGA-positive status. According to multivariate regression models, high oxHDL had a significant influence on PEW in patients, particularly those with high hsCRP. Decreased changes in GNRI and high prevalence of SGA-positive status at 1 year were more common in patients with high oxHDL at baseline and 1 year later than in patients with low oxHDL at both time points.


CONCLUSIONS
A high oxHDL state may be associated with PEW estimated by GNRI and SGA, particularly concomitant with inflammation in MHD patients.
Honda
Hirokazu
H
Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. hondah@med.showa-u.ac.jp
Ueda
Masashi
M
Kojima
Shiho
S
Mashiba
Shinichi
S
Suzuki
Hiroki
H
Hosaka
Nozomu
N
Hirai
Yuki
Y
Nakamura
Mari
M
Nagai
Hisako
H
Kato
Noriyuki
N
Mukai
Masanori
M
Watanabe
Makoto
M
Takahashi
Keiko
K
Shishido
Kanji
K
Akizawa
Tadao
T
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007564:Japan; D016014:Linear Models; D008075:Lipoproteins, HDL / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016017:Odds Ratio; D010084:Oxidation-Reduction; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000097:blood* / Q000209:etiology; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D013997:Time Factors; D015854:Up-Regulation
D015415:Biomarkers; D018836:Inflammation Mediators; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D012709:Serum Albumin; C099252:oxidized low density lipoprotein; D002097:C-Reactive Protein
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