Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Espe, KM; Raila, J; Henze, A; Blouin, K; Schneider, A; Schmiedeke, D; Krane, V; Pilz, S; Schweigert, FJ; Hocher, B; Wanner, C; Drechsler, C; German Diabetes and Dialysis Study Investigators.
Low plasma α-tocopherol concentrations and adverse clinical outcomes in diabetic hemodialysis patients.
Clin J Am Soc Nephrol. 2013; 8(3):452-458
Doi: 10.2215/CJN.04880511
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- Co-Autor*innen der Med Uni Graz
- Pilz Stefan
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- Abstract:
- Background and objectives Trials with the antioxidant vitamin E have failed to show benefit in the general population. Considering the different causes of death in ESRD, this study investigated the association between plasma concentrations of alpha-tocopherol and specific clinical outcomes in diabetic hemodialysis patients. Design, settings, participants, & measurements In 1046 diabetic hemodialysis patients (participants of the German Diabetes and Dialysis Study), alpha-tocopherol was measured in plasma by reversed-phase HPLC. By Cox regression analyses, hazard ratios were determined for prespecified end points according to baseline plasma alpha-tocopherol levels: sudden death (n=134), myocardial infarction (n=172), stroke (n=89), combined cardiovascular events (n=398), fatal infection (n=107), and all-cause mortality (n=508). Results Patients had a mean age of 66 8 years, and mean plasma alpha-tocopherol level was 22.8+/-9.6 mu mol/L. Levels of alpha-tocopherol were highly correlated to triglycerides (r=0.63, P<0.001). Patients in the lowest alpha-tocopherol quartile had (in unadjusted analyses) a 79% higher risk of stroke and a 31% higher risk of all-cause mortality compared with patients in the highest quartile. The associations were attenuated after adjustment for confounders (hazard ratio(stroke)=1.56, 95% confidence interval=0.75-3.25; hazard ratio(mortality)=1.22, 95% confidence interval=0.89-1.69, respectively). There was no association between alpha-tocopherol and myocardial infarction, sudden death, or infectious death. Conclusions Plasma alpha-tocopherol concentrations were not independently associated with cardiovascular outcomes, infectious deaths, or all-cause mortality in diabetic hemodialysis patients. The lack of association can partly be explained by a confounding influence of malnutrition, which should be considered in the planning of trials to reduce cardiovascular risk in dialysis patients. Clin J Am Soc Nephrol 8: 452-458, 2013. doi: 10.2215/CJN.04880511
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Biological Markers - blood
- Cause of Death -
- Chromatography, High Pressure Liquid -
- Chromatography, Reverse-Phase -
- Communicable Diseases - mortality
- Confounding Factors (Epidemiology) -
- Diabetic Nephropathies - blood
- Down-Regulation -
- Female -
- Female -
- Humans -
- Kaplan-Meier Estimate -
- Male -
- Malnutrition - mortality
- Middle Aged -
- Myocardial Infarction - mortality
- Proportional Hazards Models -
- Prospective Studies -
- Renal Dialysis - adverse effects
- Risk Assessment -
- Risk Factors -
- Stroke - mortality
- Time Factors -
- Treatment Outcome -
- alpha-Tocopherol - blood