Lipoprotein(a) is a predictor for cardiovascular mortality of hemodialysis patients

Koda, Yutaka; Nishi, Shinichi; Suzuki, Masashi; Hirasawa, Yoshihei

doi:10.1046/j.1523-1755.1999.07167.x

Cited by 40 publications

(25 citation statements)

References 8 publications

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“…[6][7][8][9] According to our results, the above disorders remain present and strong among those in the dialysis population, even after the exclusion of uremic patients with diabetes. The presence of these disorders was not related to patient age, sex, duration of HD therapy, or primary renal disease.…”

Section: Discussionsupporting

confidence: 55%

“…[1][2][3][4][5][6] Chronic inflammation, oxidative stress, and other nontraditional risk factors, such as increased lipoprotein(a) (Lp [a]) and fibrinogen levels, have been linked to the development of atherosclerosis in the general population and in patients receiving renal replacement therapy. [2][3][4][5][6][7][8][9][10] Dialysis patients present with elevated Lp(a) levels as well as hyperfibrinogenemia and other abnormalities of blood coagulation, inhibitory, and fibrinolytic proteins at multiple levels. [6][7][8][9] Lp(a), an acutephase protein, has been recognized as an independent risk factor of atherosclerotic cardiovascular disease in the general population and in HD patients.…”

mentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9][10] Dialysis patients present with elevated Lp(a) levels as well as hyperfibrinogenemia and other abnormalities of blood coagulation, inhibitory, and fibrinolytic proteins at multiple levels. [6][7][8][9] Lp(a), an acutephase protein, has been recognized as an independent risk factor of atherosclerotic cardiovascular disease in the general population and in HD patients. [5][6][7] A high plasma fibrinogen level in association with a high Lp(a) level increases the risk for coronary heart disease in men without renal disease and in HD patients.…”

mentioning

confidence: 99%

“…[6][7][8][9] Lp(a), an acutephase protein, has been recognized as an independent risk factor of atherosclerotic cardiovascular disease in the general population and in HD patients. [5][6][7] A high plasma fibrinogen level in association with a high Lp(a) level increases the risk for coronary heart disease in men without renal disease and in HD patients. 5,8 Recent experimental and in vivo studies provided evidence of a possible interaction and a positive correlation between Lp(a) and fibrinogen.…”

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confidence: 99%

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Relationship between lipoprotein(a), fibrinogen, and fibronectin in non‐diabetic hemodialyzed uremic patients

Tzanatos

Retsa

Soubassi

et al. 2006

Dialysis & Transplantation

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Background. Lipoprotein(a), Lp(a), has been recognized as an atherogenic and thrombogenic lipoprotein in the general population and in hemodialysis (HD) patients. In addition, fibrinogen and fibronectin may promote atherothrombosis. The aim of this study was to investigate any possible relationship between Lp(a) and thrombogenic coagulation proteins in non-diabetic HD patients. Patients and Methods. Serum Lp(a) and plasma fibrinogen, plasminogen, and fibronectin levels were measured pre-HD in 60 uremic patients (30 male, 30 female) aged 58.6 AE 8.0 years who had been receiving HD treatment for 61.3 AE 50.7 months. The control group comprised 20 age-and sex-matched healthy subjects. All patients were receiving erythropoietin treatment. Results. The mean serum Lp(a) (33.88 AE 34.12 mg/dL) and plasma fibrinogen (329.45 AE 80.62 mg/dL) levels were significantly higher in the HD patients compared with those in the controls (16.70 AE 10.36 and 254.00 AE 43.34 mg/dL, respectively; p < .05 and p < .001, respectively). Plasminogen levels did not differ between the HD patients (11.64 AE 3.22 mg/dL) and the control group (10.67 AE 1.41 mg/dL, p>.05). Fibronectin levels were slightly increased in the HD patients (33.96 AE 5.49 mg/dL) versus in the control group (30.9 AE 5.80 mg/dL, p < .05). There was a significant positive correlation between Lp(a) and fibrinogen levels (r ¼ 0.305, p < .02), as well as between Lp(a) and fibronectin levels (r ¼ 0.360, p < .01). Moreover, there was a significant positive correlation between fibrinogen and fibronectin levels (r ¼ 0.587, p < .0001). Conclusions. According to our results, in non-diabetic HD patients, abnormal serum Lp(a) levels significantly correlated with abnormal levels of fibrinogen and fibronectin. There is a concern that the relationship between these atherogenic and thrombogenic acute-phase proteins may contribute to the increased incidence of atherosclerotic cardiovascular disease in this patient population.

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Section: Discussionsupporting

confidence: 55%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Relationship between lipoprotein(a), fibrinogen, and fibronectin in non‐diabetic hemodialyzed uremic patients

Tzanatos

Retsa

Soubassi

et al. 2006

Dialysis & Transplantation

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“…This may partially explain why the association between fetuin A and dyslipidemia occurs mainly on the non-HDL-C and TG components. On the relationship between dyslipidemia and CV mortality (29)(30)(31), the relationship between high fetuin A and CV mortality warrants further investigation through larger studies because its reverse impact on CV mortality related to malnutrition and CV calcification in dialysis patients has been shown in previous studies (3,18).…”

Section: Discussionmentioning

confidence: 91%

Association of serum fetuin A with truncal obesity and dyslipidemia in non-diabetic hemodialysis patients

Chen¹,

Chiu²,

Hsu³

et al. 2009

European Journal of Endocrinology

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Background: Fetuin A, a predictor of cardio-vascular (CV) mortality in dialysis patients has been associated with dyslipidemia in non-diabetic coronary artery disease. Truncal obesity is linked to dyslipidemia and also predicts CV mortality. This study had aimed to investigate the associations among fetuin A, truncal obesity, and dyslipidemia in hemodialysis (HD) patients. Methods: One hundred and nine non-diabetic HD patients were evaluated. Waist circumference, highly sensitive C-reactive protein (hs-CRP), fetuin A, and lipoprotein levels (i.e. total cholesterol (T-CHO), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), non-HDL-C, and triglyceride (TG)) were measured for analysis of correlations. The patients were divided into tertiles by fetuin A concentrations. Results: Data from 63 women and 46 men aged 60G13 years were analyzed. Patients in the highest tertile of fetuin A (0.33-0.51 g/l) had higher serum creatinine, albumin, T-CHO, LDL-C, non-HDL-C, and TG, more truncal obesity and lower hs-CRP than patients in the lowest tertile (all P!0.05). In multi-variable linear regression analysis, fetuin A was independently associated with TG level and total iron binding capacity after adjustments for age, hemoglobin, albumin, calcium, body mass index, and hs-CRP. Patients in the highest fetuin A tertile had 3.2-and 4.4-fold higher incidence of truncal obesity (PZ0.038) and hyper-triglyceridemia (PZ0.015) independent of nutritional status and inflammation. Conclusion: Fetuin A is positively associated with truncal obesity and dyslipidemia, which are independent of malnutrition and inflammation. It may predict visceral adiposity and dyslipidemia, especially TG and TG-rich lipoproteins, in HD patients.

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Lipids and atherosclerosis

Wanner¹

2004

Replacement of Renal Function by Dialysis

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Lipoprotein(a) is a predictor for cardiovascular mortality of hemodialysis patients

Cited by 40 publications

References 8 publications

Relationship between lipoprotein(a), fibrinogen, and fibronectin in non‐diabetic hemodialyzed uremic patients

Relationship between lipoprotein(a), fibrinogen, and fibronectin in non‐diabetic hemodialyzed uremic patients

Association of serum fetuin A with truncal obesity and dyslipidemia in non-diabetic hemodialysis patients

Lipids and atherosclerosis

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