Elevated high-density lipoprotein cholesterol and cardiovascular mortality in maintenance hemodialysis patients

Nephrology Dialysis Transplantation, Journal Year: 2014, Volume and Issue: 29(8), P. 1554 - 1562

Published: Feb. 25, 2014

High-density lipoprotein (HDL) confers protection against atherosclerosis by several different mechanisms. Although in the general population, increasing levels of HDL are associated with reduced cardiovascular (CV) mortality, this association is not well known patients chronic disease states such as end-stage renal disease. We hypothesize that serum concentration and its ratio to total cholesterol all-cause CV mortality hemodialysis from population. A 3-year (July 2004 June 2007) cohort 33 109 was studied USA dialysis clinics where lipid profile measured at least 50% all outpatients clinic during a given calendar quarter. Cox proportional hazard models were adjusted for demographics case–mix variables cubic splines plotted. Higher concentrations up 50 mg/dL better overall survival, while 60 above rise mortality. All-cause 1.28 (1.20–1.38) 1.08 (1.01–1.16) <30 1.05 (1.00–1.10) (1.00–1.16) ≥ mg/dL, respectively (reference: HDL: 30–<60 mg/dL). In contrast low higher patients. U-shaped between level exists <60 exhibiting best survival. The underlying mechanisms responsible these seemingly paradoxical associations await further investigation.

Language: Английский

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HDL Cholesterol Is Not Associated with Lower Mortality in Patients with Kidney Dysfunction

Journal of the American Society of Nephrology, Journal Year: 2014, Volume and Issue: 25(5), P. 1073 - 1082

Published: March 8, 2014

In the general population, HDL cholesterol (HDL-C) is associated with reduced cardiovascular events. However, recent experimental data suggest that vascular effects of can be heterogeneous. We examined association HDL-C all-cause and mortality in Ludwigshafen Risk Cardiovascular Health study comprising 3307 patients undergoing coronary angiography. Patients were followed for a median 9.9 years. Estimated GFR (eGFR) was calculated using Chronic Kidney Disease Epidemiology Collaboration eGFR creatinine-cystatin C (eGFRcreat-cys) equation. The effect increasing serum levels assessed Cox proportional hazard models. participants normal kidney function (eGFR>90 ml/min per 1.73 m(2)), higher risk artery disease severity (hazard ratio [HR], 0.51, 95% confidence interval [95% CI], 0.26-0.92 [P=0.03]; HR, 0.30, CI, 0.13-0.73 [P=0.01]). Conversely, mild (eGFR=60-89 m(2)) more advanced (eGFR<60 did not associate lower m(2): 0.68, 0.45-1.04 [P=0.07]; 0.84, 0.50-1.40 [P=0.50]; eGFR<60 1.18, 0.60-1.81 [P=0.88]; 0.82, 0.40-1.69 [P=0.60]). Moreover, regression analyses revealed interaction between predicting (P=0.04 P=0.02, respectively). confirmed lack an independent cohort definite CKD (P=0.63). summary, function. Indeed, abnormal might confound outcome HDL-targeted therapies these patients.

Language: Английский

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The Changing Face of HDL and the Best Way to Measure It

Clinical Chemistry, Journal Year: 2016, Volume and Issue: 63(1), P. 196 - 210

Published: Nov. 23, 2016

Abstract BACKGROUND HDL cholesterol (HDL-C) is a commonly used lipid biomarker for assessing cardiovascular health. While central focus has been placed on the role of in reverse transport (RCT) process, our appreciation other cardioprotective properties continues to expand with further investigation into structure and function its specific subfractions. The development novel assays empowering research community assess different aspects function, which at some point may evolve new diagnostic tests. CONTENT This review discusses current understanding formation maturation particles via RCT, as well newly recognized roles outside RCT. antioxidative, antiinflammatory, antiapoptotic, antithrombotic, antiinfective, vasoprotective effects are all discussed, related methodologies these function. We elaborate importance protein composition health disease highlight potential based parameters. SUMMARY Although multiple epidemiologic studies have confirmed that HDL-C strong negative risk marker disease, several clinical experimental yielded inconsistent results direct an antiatherogenic factor. As yet, increased biology not translated successful therapies, but will undoubtedly depend alternative ways measuring besides content.

Language: Английский

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Understanding high-density lipoprotein function in disease: Recent advances in proteomics unravel the complexity of its composition and biology

Progress in Lipid Research, Journal Year: 2014, Volume and Issue: 56, P. 36 - 46

Published: Aug. 6, 2014

Although the epidemiology of high-density lipoprotein (HDL) cholesterol and cardiovascular risk has been consistent, pharmacologic interventions to increase HDL-cholesterol by delaying HDL catabolism did not translate into reduction in risk. particles are small, protein-rich when compared other plasma classes. Latest progresses proteomics technology have dramatically increased our understanding proteins carried HDL. In addition with well-established functions lipid transport, iron transport proteins, members complement pathway, involved immune function acute phase response were repeatedly identified on particles. With unraveling complexity proteome, different laboratories started monitor its changes various disease states. addition, dynamic aspects subgroups being discovered. These recent studies clearly illustrate promise for deriving new biomarkers diagnosis measure effectiveness current future treatment regimens. This review summarizes advances lipidomics helping understand health disease.

Language: Английский

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Beginning to Understand High-Density Lipoproteins

Endocrinology and Metabolism Clinics of North America, Journal Year: 2014, Volume and Issue: 43(4), P. 913 - 947

Published: Nov. 26, 2014

Language: Английский

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