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Published on: October 12, 2017
Cholesterol Efflux Capacity and Anti-Oxidative Activity of High-Density Lipoprotein in Chronic Kidney Disease
Hiroyuki Suzuki1,2, Masatsune Ogura3,4, Hiroko Kakita1
1Department of Nephrology and Dialysis, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai.
Insights
In chronic kidney disease (CKD) patients, high-density lipoprotein cholesterol (HDL-C) levels do not reflect HDL functionality. Impaired HDL function is linked to reduced kidney function and increased urinary protein levels.
Area of Science:
- Nephrology
- Cardiovascular Research
- Biochemistry
Background:
- Chronic kidney disease (CKD) is associated with altered lipid metabolism and impaired cardiovascular health.
- Cholesterol efflux capacity (CEC) and anti-oxidative activity are key indicators of high-density lipoprotein (HDL) functionality.
- Understanding these functionalities in CKD is crucial for managing associated risks.
Purpose of the Study:
- To investigate the alterations in cholesterol efflux capacity (CEC) and anti-oxidative activity (oxygen radical adsorption capacity, ORAC) in patients with chronic kidney disease (CKD).
- To identify clinical and kidney injury parameters related to these functional changes in CKD patients.
Main Methods:
- A retrospective cross-sectional observational study involving 333 CKD patients who underwent kidney biopsy.
- Serum samples collected during biopsy were analyzed for CEC and ORAC.
- Clinical data, including body mass index (BMI), high-density lipoprotein-cholesterol (HDL-C), serum albumin, urinary protein creatinine ratio (UPCR), and estimated glomerular filtration rate (eGFR), were evaluated.
Main Results:
- Mean CEC and ORAC were 0.83±0.15 and 0.86±0.14, respectively.
- HDL-C levels were significantly associated with both CEC and ORAC, but CEC showed only a weak association with ORAC.
- CEC and HDL-C were negatively correlated with BMI and higher in women. ORAC positively correlated with serum albumin and negatively with UPCR.
- Multiple regression analysis indicated CEC is associated with eGFR, serum albumin, and ORAC. No correlation was found between global sclerosis and CEC or ORAC.
Conclusions:
- Serum HDL-C levels are not a reliable indicator of HDL functionality in CKD patients.
- Decreased eGFR and reduced serum albumin, potentially due to increased UPCR, are associated with impaired HDL functionalities in CKD.
- These findings highlight the complex interplay between kidney function, lipid metabolism, and oxidative stress in CKD progression.
Aim:
This study addressed the alteration and related factors of cholesterol efflux capacity (CEC) and anti-oxidative activity in patients with chronic kidney disease (CKD).
Methods:
This retrospective cross-sectional observational study included 333 patients (median age: 50 [20, 81] years old, male: 46.5%) who underwent a kidney biopsy at Kitano Hospital. CEC and oxygen radical adsorption capacity (ORAC) were measured using serum obtained at the time of the kidney biopsy. Changes in CEC and ORAC in relation to the clinical and kidney injury parameters were evaluated.
Results:
Mean CEC and ORAC were 0.83±0.15 and 0.86±0.14, respectively. High-density lipoprotein-cholesterol (HDL-C) levels were significantly associated with CEC (r = 0.673, p＜0.001) and ORAC (r = 0.164, p = 0.003). CEC showed a weak association with ORAC (r = 0.333, p＜0.001). Both HDL-C and CEC were negatively associated with the body mass index (r = -0.407, p＜0.001 and r = -0.248, p＜0.001, respectively) and were significantly higher in women than in men (p＜0.001). The ORAC was positively associated with the serum albumin level (r = 0.330, p＜0.001) and negatively associated with the urinary protein creatinine ratio (UPCR) (r = -0.236, p＜0.001). A multiple regression analysis showed that CEC was associated with the estimated glomerular filtration rate (eGFR), serum albumin, and ORAC. There was no significant correlation between global sclerosis and either CEC or ORAC.
Conclusions:
The HDL-C level did not represent HDL functionalities in CKD patients. The decreased eGFR and reduced serum albumin levels induced by an increased UPCR might therefore be associated with impaired HDL functionalities.
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