title: Impact of serum apolipoprotein A-IV as a marker of cardiovascular disease in maintenance hemodialysis patients.
abstract: The aim of this study was to investigate the relationship between serum apolipoprotein (apo) A-IV levels and markers for atherosclerosis, including carotid intima-media thickness (CIMT) and the ankle-brachial index (ABI), in hemodialysis patients. We performed a cross-sectional study involving 116 maintenance hemodialysis patients (70 males; median age, 64 years), measuring CIMT, ABI, the usual laboratory examinations, and serum apo A-IV before the dialysis session. The apo A-IV concentration was measured by a noncompetitive ELISA. Serum apo A-IV concentrations were significantly lower in hemodialysis patients with cardiovascular disease and plaque in the carotid artery. The apo A-IV level was positively associated with urea nitrogen and creatinine, and negatively associated with age, interleukin-6, the neutrophil/lymphocyte ratio, and maximum CIMT. Moreover, serum apo A-IV concentrations were significantly lower in the low ABI group. On logistic analysis, patients with high apo A-IV levels had a lower odds ratio for atherosclerosis (maximum CIMT > 1.0) and cardiovascular disease compared to patients with low apo A-IV levels. On stepwise multivariate regression analysis, the serum apo A-IV level was independently associated with creatinine, the neutrophil/lymphocyte ratio, and the maximum CIMT. Serum apo A-IV is associated with atherosclerotic lesions in hemodialysis patients. Apo A-IV levels may be useful for estimating the risk of cardiovascular disease in dialysis patients.
authors.affiliation: Department of Nephrology, Gyoutoku Sougou Hospital, Chiba, Japan.
authors.forename: Maho
authors.initials: M
authors.lastname: Omori
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Kei
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Honda
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hattori
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
mesh_terms: D000328:Adult; D000368:Aged; D001054:Apolipoproteins A / Q000097:blood*; D050197:Atherosclerosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D002339:Carotid Arteries / Q000378:metabolism; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D017539:Tunica Intima / Q000378:metabolism; D017540:Tunica Media / Q000378:metabolism
chemical_list: D001054:Apolipoproteins A; D015415:Biomarkers; C022205:apolipoprotein A-IV