Serum Oxidized Albumin and Cardiovascular Mortality in Normoalbuminemic Hemodialysis Patients: A Cohort Study
Serum Oxidized Albumin and Cardiovascular Mortality in Normoalbuminemic Hemodialysis Patients: A Cohort Study
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DOI：
10.1371/journal.pone.0070822
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发表时间：
2013-07-29
期刊：
影响因子：
3.7
通讯作者：
Chen, Hung Ping
中科院分区：
文献类型：
--
作者：
Lim, Paik Seong;Jeng, Yachung;Chen, Hung Ping
背景：大量证据表明，血液透析（HD）患者氧化应激升高可能导致心血管并发症。人血清白蛋白（HSA）是血浆中最大的硫醇库，其氧化修饰改变了其生物学特性，并可能影响其在HD患者中的抗氧化潜力。方法：我们对一组正常白蛋白血症HD患者进行了长期随访研究，通过测定HSA的人非硫醇白蛋白（HNA）分数，研究血清白蛋白氧化还原状态对患者生存的影响。结果：在调整了潜在的人口统计学、人体测量学和临床混杂因素后，在正常白蛋白血症HD患者中观察到HNA水平与心血管疾病（CVD）死亡风险和全因死亡率呈正相关。通过分层分析，我们发现HNA水平与已存在CVD患者的CVD死亡风险和全因死亡率之间存在更强的相关性。结论：血清HNA水平是正常白蛋白血症HD患者死亡率的一个积极预测因子，尤其是那些已经存在CVD的患者。血清白蛋白水平生物学变化导致的氧化应激增加可能加速HD患者动脉粥样硬化和心血管疾病的发展。
Background: Substantial evidence suggests that increased oxidative stress in hemodialysis (HD) patients may contribute to cardiovascular complications. Oxidative modifications of human serum albumin (HSA), the largest thiol pool in plasma, alter its biological properties and may affect its antioxidant potential in HD patients.Methods: We conducted a long-term follow-up study in a cohort of normoalbuminemic HD patients to examine the impact of redox state of serum albumin on patients' survival by measuring the human nonmercaptoalbumin (HNA) fraction of HSA.Results: After adjusting for potential demographic, anthropometric, and clinical confounders, a positive association of HNA level with the risk of death from cardiovascular disease (CVD) and all-cause mortality was observed in normoalbuminemic HD patients. Using stratified analysis, we found a stronger association between HNA level and the risk of death from CVD and all-cause mortality in patients with pre-existing CVD.Conclusions: Serum HNA level is a positive predictor of mortality in normoalbuminemic HD patients, especially among those with pre-existing CVD. Increased oxidative stress resulting from biological changes in serum albumin levels could contribute to accelerated atherosclerosis and the development of cardiovascular disease in HD patients.