title: Relationship between Icodextrin use and decreased level of small low-density lipoprotein cholesterol fractioned by high-performance gel permeation chromatography.
abstract: BACKGROUND
  Because of the absorption of glucose in peritoneal dialysis (PD) solution, PD patients show an atherogenic lipid profile, which is predictive of poor survival in PD patients. Lipoprotein subclasses consist of a continuous spectrum of particles of different sizes and densities (fraction). In this study, we investigated the lipoprotein fractions in PD patients with controlled serum low-density lipoprotein (LDL) cholesterol level, and evaluated the effects of icodextrin on lipid metabolism.
  
  
  METHODS
  Forty-nine PD patients were enrolled in this cross-sectional study in Japan. The proportions of cholesterol levels to total cholesterol level (cholesterol proportion) in 20 lipoprotein fractions were measured using an improved method of high-performance gel permeation chromatography (HPGPC).
  
  
  RESULTS
  Twenty-six patients used icodextrin. Although no significant differences in cholesterol levels in LDL and high-density lipoprotein (HDL) were observed between the patients using icodextrin (icodextrin group) and control groups, HPGPC showed that the icodextrin group had significantly lower cholesterol proportions in the small LDL (t-test, p=0.053) and very small LDL (p=0.019), and significantly higher cholesterol proportions in the very large HDL and large HDL than the control group (p=0.037; p=0.066, respectively). Multivariate analysis adjusted for patient characteristics and statin use showed that icodextrin use was negatively associated with the cholesterol proportions in the small LDL (p=0.037) and very small LDL (p=0.026), and positively with those in the very large HDL (p=0.040), large HDL (p=0.047), and medium HDL (p=0.009).
  
  
  CONCLUSIONS
  HPGPC showed the relationship between icodextrin use and the cholesterol proportions in lipoprotein fractions in PD patients. These results suggest that icodextrin may improve atherogenic lipid profiles in a manner different from statin.
authors.affiliation: Department of Nephrology, Tokyo Kyosai Hospital, Nakameguro 2-3-8, Meguroku, Tokyo 153-8934, Japan. tokyo.kyosai.kanda@gmail.com.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Kanda
authors.forename: Masumi
authors.initials: M
authors.lastname: Ai
authors.forename: Asami
authors.initials: A
authors.lastname: Iwamoto
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Okazaki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Maeda
authors.forename: Sei
authors.initials: S
authors.lastname: Sasaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D005591:Chemical Fractionation / Q000379:methods; D008078:Cholesterol, LDL / Q000097:blood*; D002850:Chromatography, Gel / Q000379:methods*; D015314:Dialysis Solutions / Q000008:administration & dosage*; D005260:Female; D005936:Glucans / Q000008:administration & dosage*; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D000077607:Icodextrin; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D015314:Dialysis Solutions; D005936:Glucans; D000077607:Icodextrin; D005947:Glucose