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Niceritrol reduces plasma lipoprotein(a) levels in patients undergoing maintenance hemodialysis
H Nakahama1, T Nakanishi, O Uyama
1Fifth Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Insights
Patients on hemodialysis have elevated lipoprotein(a) [Lp(a)] levels, a risk factor for heart disease. Treatment with niceritrol significantly reduced Lp(a) levels in these patients.
Area of Science:
- Cardiology
- Nephrology
- Clinical Biochemistry
Background:
- Lipoprotein(a) [Lp(a)] is an LDL-like particle recognized as an independent risk factor for coronary heart disease.
- Elevated Lp(a) levels are associated with increased cardiovascular risk.
- Hemodialysis patients represent a population with potentially altered lipoprotein metabolism.
Purpose of the Study:
- To investigate plasma Lp(a) levels in patients undergoing maintenance hemodialysis.
- To assess the correlation of Lp(a) levels with clinical and biochemical parameters in hemodialysis patients.
- To evaluate the efficacy of niceritrol in reducing elevated Lp(a) levels in this cohort.
Main Methods:
- Plasma Lp(a) concentrations were measured using enzyme-linked immunosorbent assay (ELISA) in 40 hemodialysis patients.
- Lp(a) levels were compared to normal volunteers.
- A subset of patients with Lp(a) > 20 mg/dL received niceritrol (500 mg t.i.d.) for 4 weeks, with post-treatment Lp(a) levels assessed.
Main Results:
- Hemodialysis patients exhibited significantly higher median plasma Lp(a) levels (26.0 +/- 2.7 mg/dL) compared to normal volunteers (10.8 +/- 3.7 mg/dL).
- Plasma Lp(a) levels did not correlate with age, dialysis duration, total cholesterol, triglycerides, HDL, or LDL cholesterol.
- Niceritrol treatment significantly reduced Lp(a) levels in patients with elevated concentrations (38.3 +/- 4.2 to 31.5 +/- 3.2 mg/dL).
Conclusions:
- Maintenance hemodialysis is associated with significantly elevated plasma Lp(a) levels.
- Lp(a) levels in hemodialysis patients are not influenced by common metabolic parameters.
- Niceritrol demonstrates efficacy in lowering elevated Lp(a) levels in hemodialysis patients, suggesting a potential therapeutic target for cardiovascular risk reduction.
Abstract:
Lp(a) is an LDL-like lipoprotein carrying the apoprotein(a) glycoprotein and has recently been recognized to be an independent risk factor for coronary heart disease. We studied plasma Lp(a) levels in 40 patients undergoing maintenance hemodialysis (24 male, 16 female; aged 16-83 years). Fasting plasma Lp(a) levels were measured by an enzyme-linked immunosorbent assay. The median value of plasma Lp(a) concentrations in hemodialysis patients was significantly higher than that of the normal volunteers (26.0 +/- 2.7 vs. 10.8 +/- 3.7 mg/dL, p < .05). Lp(a) levels did not correlate with age, duration of hemodialysis, total cholesterol, triglyceride, HDL cholesterol, or LDL cholesterol. The 11 patients whose plasma Lp(a) concentrations exceeded 20 mg/dL received niceritrol, a prodrug of nicotinic acid, at a dosage of 500 mg t.i.d. for 4 weeks. The plasma Lp(a) levels were significantly lower after 4 weeks of treatment (38.3 +/- 4.2 vs. 31.5 +/- 3.2 mg/dL, p < .01).