Key result
Higher VLDL linked to lower ABI in peritoneal dialysis patients with controlled LDL.
Why the study?
Peripheral artery disease is a risk factor for death in peritoneal dialysis patients who tend to have an atherogenic lipid profile, but the relationship between lipid profile and ankle-brachial index in PD patients with controlled LDL cholesterol is unclear.
Is very-low-density lipoprotein (VLDL) associated with ankle-brachial index (ABI) in peritoneal dialysis patients with controlled LDL cholesterol?
Cross-Sectional (n=35)
Yes
Is very-low-density lipoprotein (VLDL) associated with ankle-brachial index (ABI) in peritoneal dialysis patients with controlled LDL cholesterol?
In peritoneal dialysis patients with controlled LDL cholesterol, higher VLDL cholesterol levels and larger VLDL particle sizes are associated with lower ankle-brachial index, suggesting a role in atherosclerosis.
BACKGROUND: Peripheral artery disease (PAD) represents atherosclerotic disease and is a risk factor for death in peritoneal dialysis (PD) patients, who tend to show an atherogenic lipid profile. In this study, we investigated the relationship between lipid profile and ankle-brachial index (ABI) as an index of atherosclerosis in PD patients with controlled serum low-density lipoprotein (LDL) cholesterol level. METHODS: Thirty-five PD patients, whose serum LDL cholesterol level was controlled at less than 120 mg/dl, were enrolled in this cross-sectional study in Japan. The proportions of cholesterol level to total cholesterol level (cholesterol proportion) in 20 lipoprotein fractions and the mean size of lipoprotein particles were measured using an improved method, namely, high-performance gel permeation chromatography. Multivariate linear regression analysis was adjusted for diabetes mellitus and cardiovascular and/or cerebrovascular diseases. RESULTS: The mean (standard deviation) age was 61.6 (10.5) years; PD vintage, 38.5 (28.1) months; ABI, 1.07 (0.22). A low ABI (0.9 or lower) was observed in 7 patients (low-ABI group). The low-ABI group showed significantly higher cholesterol proportions in the chylomicron fraction and large very-low-density lipoproteins (VLDLs) (Fractions 3-5) than the high-ABI group (ABI>0.9). Adjusted multivariate linear regression analysis showed that ABI was negatively associated with serum VLDL cholesterol level (parameter estimate=-0.00566, p=0.0074); the cholesterol proportions in large VLDLs (Fraction 4, parameter estimate=-3.82, p=0.038; Fraction 5, parameter estimate=-3.62, p=0.0039) and medium VLDL (Fraction 6, parameter estimate=-3.25, p=0.014); and the size of VLDL particles (parameter estimate=-0.0352, p=0.032). CONCLUSIONS: This study showed that the characteristics of VLDL particles were associated with ABI among PD patients. Lowering serum VLDL level may be an effective therapy against atherosclerosis in PD patients after the control of serum LDL cholesterol level.
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Kanda et al. (2013) conducted a cross-sectional in Peritoneal dialysis with controlled serum LDL cholesterol (n=35). Serum VLDL cholesterol level and VLDL particle characteristics was evaluated on Ankle-brachial index (ABI) (parameter estimate = -0.00566, p=0.0074). In peritoneal dialysis patients with controlled LDL cholesterol, ankle-brachial index was negatively associated with serum VLDL cholesterol level (parameter estimate = -0.00566, p=0.0074).
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