Metabolic syndrome in children with chronic kidney disease: PON1 and treatment modality
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Published on: June 23, 2015
Rita A Gómez-Díaz1, Juan Antonio García-Bello, Rafael Mondragón-González
1Medical Research Unit in Clinical Epidemiology, UMAE Specialty of Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.
Insights
Paraoxonase-1 (PON1) and superoxide dismutase (SOD) may predict metabolic syndrome (MetS) in children with chronic kidney disease (CKD) on dialysis. HDL-cholesterol
Area of Science:
- Pediatric Nephrology
- Metabolic Syndrome Research
- Biomarker Discovery
Background:
- Metabolic syndrome (MetS) is a growing concern in pediatric chronic kidney disease (CKD).
- Understanding the role of specific biomarkers like PON1 and SOD is crucial in this population.
- Dialysis modalities (peritoneal dialysis and hemodialysis) may influence metabolic profiles.
Purpose of the Study:
- To investigate the association between PON1, SOD, and MetS in pediatric CKD patients.
- To compare these associations across different CKD stages and dialysis treatments.
Main Methods:
- Analytical cross-sectional study involving 134 children (6-17 years old).
- Data collected included anthropometric variables, vital signs, and biochemical parameters (iPTH, hs-CRP, PON1, SOD, PON1/HDL-cholesterol, homocysteine).
- Statistical analyses employed t-tests, Mann-Whitney U, chi-square, Fisher's exact test, and regression models (SPSS v.16.0).
Main Results:
- Significant differences were found in blood pressure, C-peptide, triglycerides, HDL-cholesterol, PON1/HDL-cholesterol ratio, and SOD among patient groups.
- 66 participants were female; 39 had CKD stages 2-4 (predialysis), 42 were on hemodialysis (HD), and 53 on automated peritoneal dialysis (PD).
- Average time from diagnosis was 26 months.
Conclusions:
- PON1 and SOD show potential as predictors for MetS in pediatric patients undergoing peritoneal dialysis.
- A positive correlation in the PON1/HDL-cholesterol ratio suggests a protective role of HDL-cholesterol in CKD patients, varying by treatment modality.
Background And Aims:
We undertook this study to evaluate the relationship between PON1, SOD and metabolic syndrome (MetS) in pediatric patients undergoing peritoneal dialysis, hemodialysis and patients in early stages of CKD.
Methods:
We carried out an analytical cross-sectional study of 134 children 6-17 years old. We registered anthropometric variables, vital signs, basic biochemical parameters, intact PTH (iPTH), high sensitivity CRP (hs-CRP), paraoxonase-1; SOD; PON1/HDL-cholesterol and homocysteine. For statistical analyses we used t test, Mann Whitney U test, χ(2), Fisher exact test, linear or logistic regression models, using SPSS v.16.0. p values <0.05 were considered as significant.
Results:
There were 66 (49.3%) females; 39 (29.1%) had CKD stages 2-4 (predialysis), 42 (31.3%) on hemodialysis (HD) and 53 (39.6%) on automated peritoneal dialysis (PD). Time from diagnosis was 26 months. Significant differences were observed in mean, systolic and diastolic blood pressure, C-peptide, triglycerides, and HDL-cholesterol as well as PON1/HDL-cholesterol ratio and SOD.
Conclusions:
This study demonstrates that PON1 and SOD may be predictors for the presence of MetS in pediatric patients under treatment with peritoneal dialysis. The positive correlation observed in PON1/HDL-cholesterol ratio may reflect the protector effect of HDL-cholesterol in patients with CKD according with the modality of treatment.
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