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LDL and HDL subclass distribution in patients with end-stage renal diseases
Sonja B Alabakovska1, Bojana B Todorova, Danica D Labudovic
1Department of Medical and Experimental Biochemistry, Medical Faculty, Skopje, Republic of Macedonia. alabak@freemail.com.mk
Insights
End-stage renal disease (ESRD) patients exhibit altered LDL and HDL subclass distribution, with smaller LDL particles and reduced HDL2b levels, contributing to atherosclerosis risk.
Area of Science:
- Lipidology
- Nephrology
- Cardiovascular Disease
Background:
- End-stage renal disease (ESRD) is associated with dyslipidemia, a known risk factor for cardiovascular disease.
- Understanding lipoprotein subclass alterations in ESRD is crucial for assessing atherosclerosis risk.
Purpose of the Study:
- To analyze LDL and HDL subclass distribution in ESRD patients compared to controls.
- To investigate the relationship between LDL particle size and other plasma lipoproteins in ESRD.
Main Methods:
- Lipid profiles and lipoprotein subclasses (LDL, HDL) were analyzed in 345 controls, 42 predialysis, and 63 hemodialysis (HD) patients.
- Polyacrylamide gradient gel electrophoresis was used to separate lipoprotein subclasses.
Main Results:
- Predialysis and HD patients showed significantly smaller mean LDL particle diameter compared to controls.
- ESRD patients exhibited decreased levels of the large HDL2b subclass and increased levels of the small HDL3a subclass.
- An inverse correlation was found between LDL particle size and triglyceride levels in ESRD patients.
Conclusions:
- Altered LDL and HDL subclass distribution towards smaller particles is a key lipid abnormality in ESRD, promoting atherogenesis.
- ESRD is linked to reduced HDL2b and increased HDL3c subclasses, patterns observed in coronary artery disease.
Objectives:
To examine the alterations in LDL and HDL subclass distribution in ESRD patients compared with a control group and to investigate the relationship of LDL particle size to the other plasma lipoproteins levels.
Design And Methods:
Plasma lipids, LDL and HDL subclasses were determined in 63 hemodialysis patients (HD), 42 predialysis patients and 345 control subjects. Lipoprotein subclasses were separated by polyacrylamide 3 to 31% gradient gel electrophoresis.
Results:
In predialysis group, 88% subjects had small LDL particles compared with 58.5% of hemodialysis patients and 16.5% of control subjects. Mean LDL size particle diameter was significantly smaller in HD and predialysis patients in comparison with controls (p < 0,0005, p < 0,0001; respectively). Significant inverse correlation between LDL particle size and triglyceride level was observed for both patient groups. Decreased levels of the largest HDL2b subclass was found in both predialysis (16.5%) and in HD patients (30%) as compared with controls (50%), and increased levels of the small HDL3a subclass was found only in predialysis group (21%) in comparison with controls (4.5%).
Conclusions:
Alterations in LDL and HDL subclass distribution toward smaller particles is the main lipid abnormality associated with atherogensis found in ESRD. ESRD is associated with reduced levels of HDL2b subclass and increased levels of HDL3c subclass, which occurs in coronary artery disease (CAD) as well.