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Untersteller, K; Meissl, S; Trieb, M; Emrich, IE; Zawada, AM; Holzer, M; Knuplez, E; Fliser, D; Heine, GH; Marsche, G.
HDL functionality and cardiovascular outcome among nondialysis chronic kidney disease patients.
J Lipid Res. 2018; 59(7):1256-1265
Doi: 10.1194/jlr.P085076
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- Führende Autor*innen der Med Uni Graz
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Marsche Gunther
- Co-Autor*innen der Med Uni Graz
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Gruden Eva
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Holzer Michael
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Trieb Markus
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- Abstract:
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CVD remains the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). CKD profoundly affects HDL composition and functionality, but whether abnormal HDL independently contributes to cardiovascular events in CKD patients remains elusive. In the present study, we assessed whether compositional and functional properties of HDL predict cardiovascular outcome among 526 nondialysis CKD patients who participate in the CARE FOR HOMe study. We measured HDL cholesterol, the content of HDL-associated proinflammatory serum amyloid A (SAA), and activities of the HDL enzymes paraoxonase and lipoprotein-associated phospholipase A2 (Lp-PLA2). In addition, we assessed the antioxidative activity of apoB-depleted serum. During a mean follow-up of 5.1 ± 2.1 years, 153 patients reached the predefined primary endpoint, a composite of atherosclerotic cardiovascular events including cardiovascular mortality and death of any cause. In univariate Cox regression analyses, lower HDL-cholesterol levels, higher HDL-associated SAA content, and lower paraoxonase activity predicted cardiovascular outcome, while Lp-PLA2 activity and antioxidative capacity did not. HDL-cholesterol and HDL-paraoxonase activity lost their association with cardiovascular outcome after adjustment for traditional cardiovascular and renal risk factors, while SAA lost its association after further adjustment for C-reactive protein. In conclusion, our data suggest that neither HDL quantity nor HDL composition or function independently predict cardiovascular outcome among nondialysis CKD patients.
Copyright © 2018 Untersteller et al. Published by The American Society for Biochemistry and Molecular Biology, Inc.
- Find related publications in this database (Keywords)
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HDL function
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paraoxonase activity
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cholesterol efflux capacity
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antioxidative activity
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cardiovascular events