HDL. Impaired High-Density Lipoprotein Function is Correlated with Intima-Media Thickness of Carotid Artery in Patients with End-Stage Renal Disease

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1 HDL ESRD HDL ESRD HDL ESRD TG TC HDLC LDLC A1 ApoA1 B ApoB C hs-crp ELISA 1 VCAM-1 HDL ESRD IMT ESRD TG TC ApoB hs-crp VCAM-1 P < HDL P < ESRD IMT P < IMT r = P < ESRD TG TC ApoB hs-crp P > ESRD VCAM-1 P < ESRD HDL HDL HDL R5 A Impaired High-Density Lipoprotein Function is Correlated with Intima-Media Thickness of Carotid Artery in Patients with End-Stage Renal Disease CHEN Xiang-Hui 1 YUAN Shu-Guang 1 PENG Dao-Quan 2 ZHOU An 1 LI Jun 1 CHEN Xing 1 LIU Hong 1 and LIU Fu-You 1 1. Department of Nephrology the Second Xiangya Hospital & Institute of Nephrology Central South University & Center of Kidney Disease and Dialysis in Hunan Province 2. Department of Cardiology the Second Xiangya Hospital Central South University Changsha Hunan China KEY WORDS End-Stage Renal Disease High-density Lipoprotein Reverse Cholesterol Transport Carotid Intima Media Thickness ABSTRACT Aim To observe the change of high-density lipoprotein HDL cholesterol efflux capacity in patients with end-stage renal disease ESRD and explore its relationship with the atherosclerosis risk understand effects of a single hemodialysis on HDL cholesterol efflux capacity. Methods Serum concentration of triglyceride TG total cholesterol TC high-density lipoprotein cholesterol HDLC low-density lipoprotein cholesterol LDLC apolipoprotein A1 ApoA1 ApoB high sensitivity C-reactive protein hs-crp and soluble vascular cell adhesion molecule-1 svcam-1 in ESRD group and control group were detected and the cholesterol efflux capacity of each group were tested by liquid scintillation counter. The above indexs were detected before and after dialysis in hemodialysis group. The intima-media thickness of carotid artery CIMT in each group was measured by ultrasound. Results The serum levels of TG TC ApoB hs-crp and svcam-1 in ESRD group was significantly higher than that of control group and HDL cho Fj4168 chenxh369@ 126. com shuguangy@ hotmail. com pengdq@ hotmail. com

2 1098 ISSN Chin J Arterioscler Vol 21 No lesterol efflux capacity in ESRD group was significantly decreased than control group. CIMT in ESRD group was obviously higher than that of control group and there was an obvious negative correlation between CIMT and cholesterol efflux capacity. After a hemodialysis the cholesterol efflux rate of ESRD patients was a little higher than predialysis but the difference was not statistically significant. And there were no statistical significance of TG TC HDLC LDLC ApoB and hs- CRP levels before and after hemodialysis. Compared with predialysis the serum levels of ApoA1 and svcam-1 were significantly increased. Conclusion HDL mediated cholesterol efflux capacity in ESRD patients was significantly impaired the function change of HDL mediated cholesterol efflux may be one of the molecular mechanisms of atherosclerosis in ESRD patients. Single hemodialysis can not improve HDL cholesterol effux capacity in ESRD patients. end-stage renal disease ESRD ESRD ESRD 1 2 high-density lipoprotein ESRD 20 ESRD 30 HDL 1. 2 ESRD 3 HDL 3 ml ESRD HDL 30 min 3000 r /min 5 min high-density lipoprotein cholesterol HDLC 4 C high sensitivity C-reactive protein hs-crp - 70 HDL carotid intima media thickness CIMT 1 soluble vascular cell adhesion ELISA 5 molecule-1 svcam-1 VCAM-ELISA ESRD HDL CIMT ESRD RAW mci /L 3 H- 1 3 H - Sigma RPMI 24 h PBS % DMEM ESRD ApoB100 8 h 50 ESRD 2002 K /DOQI / 3 H- = chronic kidney cpm - cpm / cpm disease CKD glomeruar filtration rate GFR < 15 ml /min 23 Gibco 100% cpm DMEM ~ ± CIMT 38 7 B CIMT ± > < ESRD 12 CIMT 1

3 cm sity lipoprotein cholesterol LDLC CIMT ± mm tein ApoB P < ± mm P < ESRD CIMT HDLC ApoA1 P < r = ESRD low-den P < P > ESRD hs SPSS x ± s t 2. ESRD hs-crp svcam-1 Pearson HDL CI- MT P <0. 05 Table 2. Comparison of serum lipids hs-crp and svcam- 1 in ESRD patients and the control group 2 n = 30 ESRD n = 50 hemoglobin Hb albumin ALB P < CRP svcam-1 P < 2. 1 TG mmol /L ± ± b TC mmol /L ± ± a ESRD serum creatinine SCr HDLC mmol /L ± ± b blood urea nitrogen BUN uric acid UA LDLC mmol /L ± ± P < ESRD ApoA1 g /L ± ± a ApoB g /L ± ± b hs-crp mg /L ± ± b svcam-1 μg /L ± ± b a 1. ESRD P < b P < Table 1. Basic informations of ESRD patients and the control group 2. 3 ESRD HDL ESRD HDL n = 30 ESRD n = % ±4. 85% % ± 5. 29% P < / 12 /18 23 /27 HDLC HDLC ± ± kg /m ± ± HDLC <1 mmol /L HDLC > 1 mmol /L Hb g /L ± ± a ESRD HDL SCr μmol /L ± ± a 8. 18% ± 4. 45% % ± 5. 16% % ± BUN mmol /L ± ± a UA mmol /L ± ± a 3. 14% % ±3. 47% P <0. 01 ALB g /L ± ± a 2. 4 ESRD CIMT HDL a P < B ESRD 2. 2 hs-crp svcam-1 ESRD triglyceride TG ESRD total cholesterol TC B apolipopro- 1. ESRD Figure 1. Ultrasound imaging of carotid artery

4 1100 ISSN Chin J Arterioscler Vol 21 No ESRD HDL 2. ESRD HDL CIMT HDL Figure 2. The relationship of HDL cholesterol efflux function HDL and CIMT in ESRD patients ESRD 2. 5 ESRD hs-crp ESRD HDL svcam-1 ESRD TG TC HDLC LDLC ApoB hs-crp P > ATP A1 ABCA ApoA1 ApoA1 P < svcam-1 P < ABCA ESRD hs-crp sv- ABCA 1 CAM-1 9 Yamamoto 10 Table 3. Comparison of serum lipids hs-crp and svcam- 1 before and after hemodialysis in ESRD patients n = 20 n = 20 TG mmol /L ± ± TC mmol /L ± ± HDLC mmol /L ± ± LDLC mmol /L ± ± ApoA1 g /L ± ± b ApoB g /L ± ± hs-crp mg /L ± ± svcam-1 μg /L ± ± a a P < b P < ESRD HDL C 14 ESRD ESRD % ± hs-crp ESRD 2. 46% % ± 1. 98% P > ESRD HDL HDLC ESRD CIMT ESRD HDL CIMT ESRD ABCA1 ABCG1 CETP LCAT ApoA1 11 ESRD ApoA1 12 LCAT HDL HDL 13 ESRD VCAM-1 15 ESRD HDL svcam-1 ESRD

5 Bauer M Caviezel S Teynor A et al. Carotid intima-media thick- 16 N Engl J Med ness as a biomarker of subclinical atherosclerosis J Wkly w IL-1 TNF ated cholesterol efflux J LDLC ox- J. J Int Med LDL ox-ldl human coronary arterial endothelial cells J plant ESRD 11 Tall AR. Cholesterol efflux pathways and other potential mechanisms involved in the athero-protective effect of high density lipo- ESRD svcam-1 Coll Cardiol ESRD ESRD proteins J ESRD study J HDL ESRD disease J ESRD HDL theory to therapy clinic J HDL ESRD HDL Untner P He J Astor BC et al. Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease results from the Atherosclerosis Risk in Communities study J. J Am Soc Nephrol Go AS Chertow GM Fan D et al. Chronic kidney disease and the risks of death cardiovascular events and hospitalization J. N Engl J Med J J Khera AV Cuchel M de la Llera-Moya M et al. Cholesterol efflux capacity high-density lipoprotein function and atherosclerosis J.. Swiss Med 6 Asztalos BF de la Llera-Moya M Dallal GE et al. Differential effects of HDL subpopulations on cellular ABCA1-and SR-BI-medi-. J Lipid Res Tall AR. Cholesterol efflux pathways and other potential mechanisms involved in the athero-protective effect of high density lipoproteins 8 Cardinal H Raymond MA Hébert MJ et al. Uraemic plasma decreases the expression of ABCA1 ABCG1 and cell-cycle genes in. Nephrol Dial Trans- 9 Yiqin Zuo Patricia Yancey Iris Castro et al. Renal dysfunction potentiates foam cell formation by repressing ABCA1 J. Arterioscler Thromb Vasc Biol Yamamoto S Yancey PG Ikizler TA et al. Dysfunctional highdensity lipoprotein in patients on chronic hemodialysis J. J Am. Intern Med Okubo K Ikewaki K Sakai S et al. Abnormal HDL apolipoprotein A-I and A-II kinetics in hemodialysis patients a stable isotope. J Am Soc Nephrol Kaysen GA. New insights into lipid metabolism in chronic kidney. J Ren Nutr Yu H Rifin N. High sensitivity CRP and atherosclerosis from. Biochemistry Linhartova K Sterbakova G Racek J et al. Linking soluble vascular adhesion molecule-1 level to calcific aortic stenosis in patients with coronary artery disease J. Exp Clin Cardiol Musia K Zwolińska D Polak-Jonkisz D et al. Soluble adhesion molecules in children and young adults on chronic hemodialysis J. Pediatr Nephrol Kinlay S Ganz P. Role of endothelial dysfunction in coronary artery disease and implications for therapy J. Am J Cardicl A J

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