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Paraoxonase activity in glomerulonephritic patients
Mustafa Gullulu1, Serdar Kahvecioglu, Melahat Dirican
1Department of Nephrology, University Medical School, Bursa, Turkey. kserdar@uludag.edu.tr
Insights
Patients with glomerulonephritis (GN) show increased lipoprotein oxidation and lower paraoxonase-1 (PON1) activity, even with normal creatinine and lipid levels. This highlights a risk for cardiovascular disease in GN patients.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Biochemistry
Background:
- Cardiovascular disease (CVD) is a leading cause of death in chronic renal failure patients.
- Glomerulonephritis (GN) patients face elevated CVD risk, with unclear underlying mechanisms.
- Lipoprotein oxidizability and paraoxonase (PON) enzyme activity are implicated in atherosclerosis development.
Purpose of the Study:
- To investigate lipoprotein oxidizability and paraoxonase/arylesterase activities in glomerulonephritis patients.
- To assess these factors in GN patients with normal lipid and creatinine levels.
Main Methods:
- Compared 32 glomerulonephritis patients with 22 healthy controls.
- Analyzed serum and urinary paraoxonase and arylesterase activities.
- Measured serum lipids, urea, creatinine, and other biochemical parameters.
Main Results:
- Glomerulonephritis patients exhibited significantly higher apolipoprotein B-containing lipoprotein oxidizability compared to controls.
- Paraoxonase-1 (PON1) activity was significantly lower in the GN group.
- Serum urea, creatinine, lipids, and protein levels were similar between groups.
Conclusions:
- Elevated lipoprotein oxidizability and reduced PON1 activity in GN patients are significant, even with normal creatinine and lipid profiles.
- These findings underscore the importance of considering cardiovascular risk in GN patients.
- Prompt initiation of preventive and curative treatments is recommended to mitigate cardiovascular and renal risks.
Background:
Cardiovascular disease is the most common cause of morbidity and mortality in patients with chronic renal failure. Glomerulonephritic patients have an increased risk for cardiovascular disease, but its etiology is unclear. It is known that an increase in oxidizability of apolipoprotein B-containing lipoproteins has a key role in the initiation of atherosclerosis, and paraoxonase enzyme activity particularly has a preventive role against atherosclerosis. The aim of the present study was to evaluate the oxidizability of apolipoprotein B-containing lipoproteins, serum, and urinary paraoxonase/arylesterase activities in glomerulonephritis patients who had normal lipid parameters and creatinine levels.
Methods:
Thirty-two patients with glomerulonephritis and 22 healthy controls were included in this study. A total of 32 patients (including nine with membranous GN, eight with immunoglobulin A nephropathy, eight with mesangial proliferative GN, five with focal-segmental glomerulosclerosis, one with diffuse proliferative GN, and one with minimal chance disease having biopsy proven GN) were enrolled into the study. We compared serum and urinary paraoxonase, arylesterase, serum lipids, urea, creatinine, hemoglobin, total protein and albumin values between groups.
Results:
Serum urea, creatinine, total protein, albumin, uric acid, hemoglobin, and lipid parameters were similar in the glomerulonephritis and control groups (p > 0.05). PON1 activity was significantly lower in GN group than controls, but there was no statistically significant difference on arylesterase activity between groups. Oxidizability of apolipoprotein B-containing lipoproteins was significantly higher in GN group than controls.
Conclusion:
Our study shows that the findings of normal serum levels of creatinine, lipids, and proteins increased the oxidizability of apolipoprotein B-containing lipoproteins, and any decrease in PON1 activity in patients diagnosed with GN should be considered important. Hence, the immediate commencement of preventive as well as curative treatment in other to avoid the risk of cardiovascular and renal problems would be a correct approach.
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