What question did this study set out to answer?

This research aims to explore the association between serum anti-oxLDL antibodies and peripheral arterial disease (PAD) in patients undergoing peritoneal dialysis (PD).

April 8, 2026Open Access

Decreased Serum Antibodies Against Oxidized Low-Density Lipoprotein Levels Are Associated with Peripheral Arterial Disease in Patients Undergoing Peritoneal Dialysis

Key Points

This research aims to explore the association between serum anti-oxLDL antibodies and peripheral arterial disease (PAD) in patients undergoing peritoneal dialysis (PD).
Conducted a cross-sectional study involving 90 patients on maintenance peritoneal dialysis.
Defined PAD using an ankle-brachial index (ABI) below 0.90.
Quantified serum anti-oxLDL antibody concentrations via enzyme-linked immunosorbent assay (ELISA).
Performed multivariable logistic regression to assess associations with PAD.
Patients with PAD were older and had higher rates of diabetes and triglycerides.
Lower serum anti-oxLDL Ab levels were observed in PAD patients compared to those without.
Reduced anti-oxLDL Ab levels and increased CRP levels were independently associated with PAD.
Anti-oxLDL Ab levels showed positive correlations with ABI values, suggesting their relevance for vascular health.

Abstract

Background and Objectives: Peripheral arterial disease (PAD) is highly prevalent in patients with end-stage renal disease and is associated with adverse cardiovascular outcomes. Although the ankle–brachial index (ABI) is widely used to identify PAD, it may not fully reflect the complex vascular pathophysiology in patients undergoing peritoneal dialysis (PD). Antibodies against oxidized low-density lipoprotein (anti-oxLDL Ab) have been implicated in atherogenesis; however, their clinical relevance in PD populations remains unclear. Materials and Methods: In this cross-sectional investigation, 90 patients receiving maintenance PD were included. PAD was defined by an ABI below 0.90, and serum anti-oxLDL antibody concentrations were quantified using an enzyme-linked immunosorbent assay. Results: Patients with PAD were older (p = 0.006), had a higher prevalence of diabetes (p = 0.010), and exhibited higher levels of triglycerides (p = 0.008), fasting glucose (p < 0.001), and C-reactive protein (CRP, p < 0.001), but lower anti-oxLDL Ab levels (p = 0.008). Multivariable logistic regression demonstrated that reduced anti-oxLDL Ab levels (per 10 mU/mL increase, odds ratio OR: 0.803, 95% confidence interval CI: 0.648–0.995, p = 0.045) and increased CRP levels (per 0.1 mg/dL increase, OR: 1.662, 95% CI: 1.152–2.398, p = 0.007) were independently associated with PAD, with consistent results across penalized regression models. Log-transformed anti-oxLDL Ab levels were positively correlated with both left and right ABI values (p = 0.005 and p = 0.017, respectively). Decision curve analysis indicated that the anti-oxLDL Ab-based model provided greater net benefit compared with the treat-all and treat-none strategies across a range of threshold probabilities. Conclusions: Reduced serum anti-oxLDL Ab levels are independently associated with PAD in patients undergoing PD. Serum anti-oxLDL Ab levels are positively associated with ABI values. These findings suggest that impaired immunity against oxidized LDL may contribute to vascular disease in PD patients.

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