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Lipophilic antioxidants and iron status in ESRD patients on hemodialysis
Insights
Hemodialysis patients have lower levels of key lipophilic antioxidants, crucial for combating oxidative stress. Elevated iron stores, indicated by serum ferritin, further deplete these protective compounds, impacting cardiovascular health.
Area of Science:
- Nephrology
- Nutritional Biochemistry
- Cardiovascular Medicine
Background:
- Cardiovascular disease is the leading cause of death in hemodialysis patients.
- Oxidative stress and impaired antioxidant defenses are implicated in uremic atherogenesis.
- Lipophilic antioxidants may offer protection against oxidative modification of lipids, a precursor to atherosclerosis.
Purpose of the Study:
- To measure plasma levels of lipophilic antioxidants in hemodialysis patients and controls.
- To examine the relationship between body iron status (serum ferritin) and lipophilic antioxidant levels.
- To investigate the potential of lipophilic antioxidants as markers of oxidative stress in end-stage renal disease.
Main Methods:
- Plasma levels of lycopene, tocopherols (delta, gamma), retinol, beta-carotene, and alpha-carotene were quantified.
- 82 hemodialysis patients and 30 healthy controls were included.
- Patients were stratified into three groups based on serum ferritin levels to assess iron status impact.
Main Results:
- Hemodialysis patients exhibited lower plasma concentrations of lycopene, delta-tocopherol, gamma-tocopherol, and retinol compared to controls.
- Higher serum ferritin levels correlated with significantly reduced absolute and lipid-normalized plasma lycopene.
- Elevated ferritin was also associated with lower lipid-normalized beta-carotene and alpha-carotene levels in patients.
Conclusions:
- Plasma lipophilic antioxidant levels are significantly altered in hemodialysis patients.
- These antioxidants may serve as indicators of oxidative stress in end-stage renal disease.
- Elevated serum ferritin levels appear to negatively influence the status of key lipophilic antioxidants in this population.
Abstract:
Cardiovascular disease remains the major cause of mortality in hemodialysis patients. Abnormal oxidative stress and impaired antioxidant defense may contribute to accelerated atherogenesis associated with uremia. As oxidative modification of lipids appears to be a prerequisite for the development of atherosclerotic lesions, lipophilic antioxidants may be protective. The aim of this study was to determine the plasma levels of lipophilic antioxidants in 82 hemodialysis patients and 30 controls and to investigate the influence of body iron status on the levels of lipophilic antioxidants. The patients were categorized into 3 groups according to their serum ferritin levels. We found that the plasma levels of lycopene, delta-tocopherol, gamma-tocopherol and retinol of hemodialysis patients were lower than those of controls. On the other hand, both absolute and lipid-normalized plasma lycopene levels were significantly reduced in those patients in the groups with higher ferritin levels as compared to those with lower ferritin levels. In addition, our study showed that the lipid-normalized plasma levels of beta-carotene and alpha-carotene of hemodialysis patients with higher ferritin levels were lower than those of the patients with lower levels. These data suggest that the plasma levels of lipophilic antioxidants are altered in end-stage renal disease on hemodialysis and may be considered as markers of oxidative stress in these patients. Most importantly, elevated serum ferritin levels may affect the levels of these lipophilic antioxidants.