Serum malondialdehyde and prevalent cardiovascular disease in hemodialysis
Serum malondialdehyde and prevalent cardiovascular disease in hemodialysis
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DOI：
10.1046/j.1523-1755.1999.00613.x
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发表时间：
1999-09-01
影响因子：
19.6
通讯作者：
Smetana, S
中科院分区：
文献类型：
--
作者：
Boaz, M;Matas, Z;Smetana, S
背景氧化应激被认为是一种机制，可以解释在维持性血液透析（HD）患者中观察到的心血管疾病（CVD）的加速发生率。本研究检测了HD和CVD对血清丙二醛（MDA）水平的影响，MDA水平是伴有和不伴有CVD的HD患者的氧化应激标志物。对HD患者的血清MDA水平和CVD患病率进行建模。使用分光光度法测定HD患者（N = 76，53名男性和23名女性，平均年龄63.8岁）在一次周中HD治疗之前和结束时的血清MDA。传统的心血管疾病危险因素，包括血脂、脂蛋白、载脂蛋白和纤维蛋白原，也被测量，如血清化学和透析充分性。平均血清MDA水平显着升高HD患者与流行的CVD相比，而血清脂蛋白和血浆纤维蛋白原水平没有显着差异，两组之间。透析后MDA水平最高的患者与最低的三分位数患者相比，患心血管疾病的可能性几乎是四倍，血清MDA是该患者人群中心血管疾病流行的单一最强预测因子。这些发现表明HD患者存在氧化应激，并且与氧化应激作为该人群中加速CVD的因素的理论一致。
Background. Oxidative stress has been proposed as a mechanism by which the accelerated rate of cardiovascular disease (CVD) observed in maintenance hemodialysis (HD) patients may be explained. This study examined the effects of HD and CVD on serum malondialdehyde (MDA) levels as a marker of oxidative stress in HD patients with and without prevalent CVD. Serum MDA levels and CVD prevalence in HD were modeled.Methods. Serum MDA was determined using spectrophotometry in HD patients (N = 76, 53 men and 23 women, mean age 63.8 years) immediately prior to and at the conclusion of one midweek HD treatment. Traditional CVD risk factors, including serum lipids, lipoproteins, apolipoproteins, and fibrinogen, were also measured, as were serum chemistry and dialysis adequacy.Results. Mean serum MDA levels were significantly elevated in HD patients with prevalent CVD compared with those without, whereas serum lipoprotein and plasma fibrinogen levels did not differ between the two groups. Patients in the highest compared with the lowest tertile of postdialysis MDA were nearly four times as likely to have prevalent CVD, and serum MDA was the single strongest predictor of prevalent CVD in this patient population.Conclusions. These findings indicate the presence of oxidative stress in HD patients, and are consistent with the theory of oxidative stress as a factor in accelerated CVD in this population.