Abstract
Circulating malondialdehyde-modified low-density lipoprotein (MDA-LDL) acts as a marker of oxidative stress and is associated with atherosclerotic cardiovascular disease. The relationship between serum MDA-LDL levels and aortic stiffness (AS) in patients with hemodialysis (HD) was evaluated. There were 155 HD patients enrolled in this study. Carotid-femoral pulse wave velocity (cfPWV) was measured by a validated tonometry system. Patients with cfPWV >10 m/s were used to define the AS group, while those with values of ≤10 m/s were regarded as the control group. Serum MDA-LDL levels were measured using a commercial enzyme-linked immunosorbent assay. Sixty-eight patients (43.9%) who were defined as AS sufferers, and were older, had a higher percentage of diabetes and hypertension and higher systolic blood pressure and serum MDA-LDL level compared to subjects in the control group. After adjusting for factors significantly associated with AS by multivariable logistic regression analysis, it was revealed that serum MDA-LDL levels, diabetes, and hypertension were independent predictors of AS in HD patients. Multivariable forward stepwise linear regression analysis also showed that a logarithmically transformed MDA-LDL level was significantly correlated with cfPWV values in HD patients. In HD patients, a high serum MDA-LDL level was positively associated with cfPWV values and was a significant predictor of the development of high AS.
Highlights
Cardiovascular disease (CVD), for which traditional risk factors include diabetes mellitus (DM)and hypertension (HTN), as well as chronic kidney disease (CKD)-specific risk factors, has long been known as the main cause of adverse long-term outcomes in patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis (HD) [1]
Nutrients 2020, 12, 2160 wave ascending to aorta during systole, which together leads to high stress on central vasculature, as well as increased pulse pressure exposure to those feeding arteries or low impedance vasculature with the results of high blood pressure and mechanical strain to organ parenchyma and future cardiovascular (CV) events [2,4,5]
The results showed that Carotid-femoral pulse wave velocity (cfPWV) was significantly positively correlated with age, DM, HTN, SBP, as well as logarithmically transformed glucose and MDA-low-density lipoprotein (LDL) by simple linear regression analysis
Summary
Cardiovascular disease (CVD), for which traditional risk factors include diabetes mellitus (DM)and hypertension (HTN), as well as chronic kidney disease (CKD)-specific risk factors, has long been known as the main cause of adverse long-term outcomes in patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis (HD) [1]. Evidence has shown that the stiffening of vascular walls caused by deregulation of elastin and collagen, oxidative stress, disordered mineral metabolisms, and low-grade inflammation, may result in increased myocardial pre-load, and a decrease in perfusion pressure of the coronary artery and future CVD in CKD patients [2,3]. Nutrients 2020, 12, 2160 wave ascending to aorta during systole, which together leads to high stress on central vasculature, as well as increased pulse pressure exposure to those feeding arteries or low impedance vasculature with the results of high blood pressure and mechanical strain to organ parenchyma and future cardiovascular (CV) events [2,4,5]. Pulse-wave velocity (PWV), which is a way to measure vascular function non-invasively and is a surrogate marker of aortic stiffness (AS), has been considered to be associated strongly with future CV events and mortality in ESRD patients, irrespective of traditional. Circulating malondialdehyde-modified low-density lipoprotein (MDA-LDL), which is a type of oxidized LDL with malondialdehyde-modified (MDA) adduction onto apolipoprotein
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