Oxidative Modification of Low-Density Lipoprotein in Relation to Dyslipidemia and Oxidant Status in Children With Steroid Sensitive Nephrotic Syndrome

Abstract

It has been proposed that nephrotic syndrome is a consequence of an imbalance between oxidant/antioxidant statuses. The present study aimed to assess oxidant and antioxidant status in relation to dyslipidemia in children during remission and relapse phases of steroid sensitive nephrotic syndrome (SSNS). The study dealt with 40 children diagnosed as SSNS. They were categorized into two subgroups. The first subgroup included 25 children during remission stage. The second subgroup included 15 children during relapse. Control group consisted of age and gender-matched 15 healthy children. Significantly higher serum levels of malondialdehyde, oxidized LDL, total cholesterol, LDL cholesterol, triglycerides, apolipoprotein A-I, and apolipoprotein-B were observed in patients with SSNS especially in the relapsers. The serum levels of albumin, glutathione peroxidase activity, vitamin C, A, and E, and HDL cholesterol were significantly lower in patients especially among relapsers. In conclusion, a strong relationship between the oxidant/ antioxidant status and dyslipidemia is documented in patients with SSNS, especially among relapsers. No normalization of the biochemical indices was observed despite the use of glucocorticoids. Therefore, the combined use of steroid, antioxidant therapy, and lipid lowering therapy can be recommended in such children.

Serum levels of malondialdehyde, vitamin C and E in idiopathic nephrotic syndrome: a meta-analysis

“…First, free radicals are possible mediators of injury in nephrosis by enhancing permeability of the glomerular capillary wall, 26 meanwhile, dyslipidemia of INS is known to be associated with oxidative stress. 12 Hence, MDA, by-product of lipid membranes peroxidation, would increase due to the above-mentioned mechanisms, similar results were observed in the active or remission stage of INS in our study. Second, the antioxidants, such as vitamin C and E, would decline because of the consumption of oxidative stress.…”

“…This is possibly attributable to the fact that the clinical and pathological changes of SSNS are relatively mild, the impact on the gastrointestinal absorption is not severe, and the loss of vitamin C and E may be offset by intake of extra nutrition. Of note, subjects in the remission stage of INS showed markedly decreased levels of vitamin C. This is probably because that the subjects included were frequent relapse of INS, and vitamin C is water-soluble which is more likely to lose compared with vitamin E. Moreover, only one study by ElMelegy et al 12 investigated this issue, which made the results less robust. Further studies should be performed in the future.…”

“…To date, several studies [9][10][11][12][13][14][15][16] have showed the alterations of these parameters in the INS subjects. However, the relative small number of participants limited the statistical power, and some of the results were in conflict.…”

The study of lipid profile, LP (a) and electrolytes with oxidative stress, total protein and albumin in nephrotic syndrome

“…The serum level of albumin, glutathione peroxidase activity, Vitamin C, Vitamin E and HDLc were significantly lower, a significant strong relationship between the oxidant/antioxidant status and dyslipidemia was documented in patients with steroid sensitive nephrotic syndrome, especially among relapsers. 25 Scrzep-Polozek B et al showed that higher amounts of electro negatively charged (oxidized) LDL particles as well as different oxysterol in patients have also been reported, significant disturbances in oxidant/antioxidant status during NS leading to plasma accumulation of oxidized LDLc and cholesterol oxidation products that exert cytotoxicity and were known to induce atherosclerosis.…”

Evaluation of Vitamin E, Selenium and Glutathione Peroxidase Activity in Patients with Disseminated Intravascular Coagulation

“…Çalışmamızda DİK gelişimi üzerine etkisini araştırdığımız antioksidan ajanların sağlıklı çocuklardaki ortalama kan değerleri sırasıyla vitamin E için 5-16 mg/L, selenyum için 63-106 µg/L ve GPx için ise 180-250 U/L olarak bildirilmiştir (17,18). Sağlıklı kontrol grubu ile karşılaştırmalı değerlendirme imkanımızın olmadığı bu çalışmada belirgin DİK (DİK≥5) tespit ettiğimiz hastalarda diğer gruba göre (DİK< 5) selenyum, vitamin E düzeyleri ve GPx aktivitesini anlamlı ölçüde düşük ve mortalitenin de yüksek olduğunu tespit ettik.…”