Study shows HDL not predictive of cardiovascular disease in chronic patients with CKD
For patients with non-dialysis chronic kidney disease, HDL quantity, composition and function cannot independently predict cardiovascular outcomes, according to study published in The Journal of Lipid Research.
“HDL-[cholesterol] is a robust biochemical predictor of cardiovascular disease risk in the general population. In contrast, plasma levels of HDL-[cholesterol] are not associated with cardiovascular events in CKD patients,” Kathrin Untersteller, MD, of Saarland University Medical Center, and colleagues wrote. “Interestingly, increasing serum HDL-[cholesterol] over time is paradoxically associated with worse outcomes in incident hemodialysis patients, underlining the shortcomings of serum HDL concentrations in predicting outcomes.”
The study examined compositional and functional properties of HDL, while monitoring cardiovascular outcomes in 526 patients with non-dialysis CKD who participated in the ongoing Cardiovascular and Renal Outcome in CKD 2-4 Patients - The Fourth
Homburg Evaluation study. All participants were Caucasian. Researchers collected data on HDL-cholesterol, the content of HDL-associated pro-inflammatory serum amyloid A (SAA), activity of the HDL enzymes paraoxonase, and lipoprotein-associated phospholipase A2 (Lp-PLA), as well as measured the anti-oxidative activity of aopB-depleted serum. Follow-up examinations were conducted annually, with a mean of 5.1 to 2.1 years, to monitor for cardiovascular events.
Investigators found no evidence of Lp-PLA and aopB-depleted serum activity predicting cardiovascular events. Initially, lower HDL-cholesterol levels and HDL-paraoxonase activity predicted cardiovascular outcomes but could not do so independently after traditional risk factors were accounted for in the study. Similarly, higher SAA content predicted cardiovascular outcomes, but failed to do so independently after adjustments for C-reactive protein were made. – by Laura Kincaid
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