title: Association of High-Density Lipoprotein Subclasses with Chronic Kidney Disease Progression, Atherosclerosis, and Klotho.
abstract: BACKGROUND
  Atherosclerosis is often a complication of chronic kidney disease (CKD) because of dyslipidemia and CKD-mineral and bone disorder. High-density lipoproteins (HDLs) are grouped into various subclasses composed of multiple proteins and lipids, and their transformation is altered in CKD. We investigated the roles of lipoprotein subclasses in CKD progression, and atherosclerosis, and the relationships with Klotho and fibroblast growth factor (FGF) 23.
  
  
  METHODS
  Seventy-one CKD patients were enrolled in this prospective cohort study in Japan. The proportions of cholesterol level to total cholesterol level (cholesterol proportion) and lipoprotein particle numbers in 20 lipoprotein fractions were measured by a newly developed high-performance gel permeation chromatography.
  
  
  RESULTS
  Diabetic nephropathy was observed in 23.9% of the patients. The mean age was 75.0 years and estimated glomerular filtration rate (eGFR) was 17.2 ml/min./1.73m2. The lipoprotein particle numbers in small HDLs were higher in Stage 4 group than in Stage 5 group (p = 0.002). Multivariate regression analysis adjusted for baseline characteristics showed that the cholesterol proportions in very small HDLs were associated with eGFR change rate [F19 β = -17.63, p = 0.036] and ABI [F19 β = 0.047, p = 0.047] in Stage 4 group, and that serum soluble α-Klotho level was associated with the lipoprotein particle numbers in very small HDLs [F19 β = 0.00026, p = 0.012; F20 β = 0.00041, p = 0.036] in Stage 5 group.
  
  
  CONCLUSIONS
  This study showed that HDL subclasses are associated with CKD progression, ABI, and Klotho level in CKD-stage-specific manner.
authors.affiliation: Department of Nephrology, Tokyo Kyosai Hospital, Meguroku, Tokyo, Japan.|Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University, Bunkyoku, Tokyo, Japan.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Kanda
authors.affiliation: Department of Insured Medical Care Management, Graduate School of Medicine, Tokyo Medical and Dental University, Bunkyoku, Tokyo, Japan.
authors.forename: Masumi
authors.initials: M
authors.lastname: Ai
authors.affiliation: Tokyo Medical and Dental University, Bunkyoku, Tokyo, Japan.
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Okazaki
authors.affiliation: Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University, Bunkyoku, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Nephrology, JA Toride Medical Center, Toride, Ibaraki, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Maeda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology; D015415:Biomarkers; D002784:Cholesterol / Q000097:blood; D018450:Disease Progression; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005919:Glomerular Filtration Rate; D005966:Glucuronidase / Q000097:blood*; D006801:Humans; D000090265:Klotho Proteins; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D008075:Lipoproteins, HDL; D000089703:Fibroblast Growth Factor-23; D002784:Cholesterol; D005966:Glucuronidase; D000090265:Klotho Proteins