Abstract
Some observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients. We have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio. ESRD patients with adjusted 25(OH)D concentrations of 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDLC (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L. Our study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.
Highlights
End stage renal disease (ESRD) is associated with apolipoprotein abnormalities and dyslipidemia [1,2,3]
Altered lipid metabolism is usually deemed to be a consequence of renal disease, but a large body of clinical and experimental studies support the fact that there is inter-dependence of vitamin D levels with serum lipid profiles in ESRD patients [4]
The aim of this study was to evaluate the concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TG, ApoAI, apolipoprotein B (ApoB) and Lp(a) in ESRD patients in relation to control group (CG) participants and in relation to 25(OH)D concentrations (< 50 nmol/L and 50 nmol/L)
Summary
End stage renal disease (ESRD) is associated with apolipoprotein abnormalities and dyslipidemia [1,2,3]. Altered lipid metabolism is usually deemed to be a consequence of renal disease, but a large body of clinical and experimental studies support the fact that there is inter-dependence of vitamin D levels with serum lipid profiles in ESRD patients [4]. Some investigations have proposed that there is potential association of vitamin D binding protein (DBP) with lipoproteins in chronic renal failure, and that significant urinary DBP losses contributing to vitamin D deficiency [5]
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