P1266SERUM MALONDIALDEHYDE-MODIFIED LOW-DENSITY LIPOPROTEIN LEVEL IS A RISK FOR AORTIC STIFFNESS IN MAINTENANCE HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims Circulating oxidized malondialdehyde LDL (MDA-LDL) induced macrophage apoptosis, the release of higher levels of matrix metalloproteinases and TNF-α, therefore, act as a marker of oxidative stress and are associated with atherosclerotic cardiovascular diseases. We evaluated the association between serum MDA-LDL levels and aortic stiffness in patients with hemodialysis (HD). Method A total of 155 patients with HD were enrolled in this study. Carotid-femoral pulse wave velocity (cfPWV) value was measured by a validated tonometry system (SphygmoCor). Patients with cfPWV >10 m/s were used to define the aortic stiffness group, while values ≤ 10 m/s were regarded as the control group, according to the ESH-ESC 2013. Serum MDA-LDL levels were measured using a commercial enzyme-linked immunosorbent assay. Results 68 patients (43.9%) had aortic stiffness and higher percentages of diabetes (p < 0.001), hypertension (p = 0.017), and had older age (p = 0.038), higher systolic blood pressure (P = 0.021), serum MDA-LDL level (p < 0.001) compared to subjects with control group. After adjusting for factors significantly associated with aortic stiffness by multivariable logistic regression analysis revealed that serum MDA-LDL levels (odds ratio (OR): 1.014, 95% confidence interval (CI): 1.007–1.021, p < 0.001), diabetes (OR: 2.893, 95% CI: 1.300–6.437, p = 0.009), and hypertension (OR: 2.408, 95% CI: 1.066–5.436, p = 0.034) were the independent predictors of aortic stiffness in HD patients. Multivariable forward stepwise linear regression analysis also showed that serum logarithmically transformed MDA-LDL level (log-MDA-LDL, β = 0.404, adjusted R2 change = 0.265, p < 0.001), diabetes (β = 0.233, adjusted R2 change = 0.055, p = 0.001), and hypertension (β = 0.132, adjusted R2 change = 0.014, p = 0.048) were the independent predictors of cfPWV values in HD patients. The area under the receiver-operating characteristic (ROC) curve predicting aortic stiffness by serum MDA-LDL level in HD patients was 0.721 (95% CI: 0.643-0.790, p < 0.001). Conclusion In this study, high serum MDA-LDL level was positively associated with cfPWV values and thus was related to aortic stiffness in HD patients.