1
|
Chang CT, Shen MY, Lee AS, Wang CC, Chen WY, Chang CM, Chang KC, Stancel N, Chen CH. Electronegative low-density lipoprotein increases the risk of ischemic lower-extremity peripheral artery disease in uremia patients on maintenance hemodialysis. Sci Rep 2017; 7:4654. [PMID: 28680087 PMCID: PMC5498573 DOI: 10.1038/s41598-017-04063-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/08/2017] [Indexed: 12/31/2022] Open
Abstract
Electronegative low-density lipoprotein (LDL) has been shown to increase coronary artery disease risk in hemodialysis patients, but its effect on the risk of peripheral artery disease (PAD) remains unclear. We separated plasma LDL from 90 uremia patients undergoing hemodialysis into 5 subfractions (L1-L5) according to charge by using fast-protein liquid chromatography with an anion-exchange column and examined the distribution of L5-the most electronegative LDL subfraction-in total LDL (i.e. L5%). During a 5-year period, we followed up with these patients until the occurrence of ischemic lower-extremity PAD. During the follow-up period, ischemic lower-extremity PAD developed in 24.4% of hemodialysis patients. L5% was higher in hemodialysis patients in whom ischemic lower-extremity PAD occurred (3.03% [IQR, 2.36-4.54], n = 22) than in hemodialysis patients in whom PAD did not occur (1.13% [IQR, 0.90-1.83], n = 68) (p < 0.001). Furthermore, L5% significantly increased the adjusted hazard ratio of ischemic lower-extremity PAD (1.54 [95% CI, 1.14-2.10]) (p = 0.005). Flow-mediated dilation was negatively associated with L5% (p < 0.001). Additionally, in vivo experiments from mice showed that L5 compromised endothelium-dependent vascular relaxation through a nitric oxide-related mechanism. Our findings indicate that increased L5% may be associated with the occurrence of ischemic lower-extremity PAD in hemodialysis patients.
Collapse
Affiliation(s)
- Chiz-Tzung Chang
- Division of Nephrology, China Medical University Hospital (CMUH), Taichung, Taiwan.,Cardiovascular Research Laboratory, CMUH, Taichung, Taiwan.,College of Medicine, China Medical University (CMU), Taichung, Taiwan
| | - Ming-Yi Shen
- Graduate Institute of Clinical Medical Science, CMU, Taichung, Taiwan.,Department of Medical Research, CMUH, Taichung, Taiwan
| | - An-Sean Lee
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan
| | - Chun-Cheng Wang
- Cardiovascular Research Laboratory, CMUH, Taichung, Taiwan.,College of Medicine, China Medical University (CMU), Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, CMU, Taichung, Taiwan
| | - Wei-Yu Chen
- Cardiovascular Research Laboratory, CMUH, Taichung, Taiwan
| | | | - Kuan-Cheng Chang
- Cardiovascular Research Laboratory, CMUH, Taichung, Taiwan.,College of Medicine, China Medical University (CMU), Taichung, Taiwan
| | - Nicole Stancel
- Vascular and Medicinal Research, Texas Heart Institute, Houston, TX, United States
| | - Chu-Huang Chen
- Vascular and Medicinal Research, Texas Heart Institute, Houston, TX, United States. .,Lipid Science and Aging Research Center, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan. .,Center for Lipid Biosciences, KMU Hospital, Kaohsiung, Taiwan.
| |
Collapse
|
2
|
Enhancement of arterial pulsation during flow-mediated dilation is impaired in the presence of ischemic heart disease. SPRINGERPLUS 2016; 5:1103. [PMID: 27468404 PMCID: PMC4947464 DOI: 10.1186/s40064-016-2794-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/07/2016] [Indexed: 11/10/2022]
Abstract
Purpose The aim of this study is to investigate the relationship between arterial pulse amplitude change under increased shear stress and the presence of ischemic heart disease (IHD). Methods This study comprised 31 subjects, including 14 subjects with IHD. We investigated the change in brachial artery pulse amplitude during flow-mediated dilation (FMD) using ultrasonography. Results The arterial pulse amplitude increased during FMD in 19 subjects, whereas it decreased in 12 subjects. There was a marked difference in the change in arterial pulse amplitude (the maximum amplitude of the arterial pulse amplitude during FMD/the arterial pulse amplitude at baseline) between subjects with and without IHD (0.98 ± 0.53 and 1.37 ± 0.53, p = 0.028). Furthermore, decreased arterial pulse amplitude during FMD was a significant predictor of IHD after adjustment of age, blood pressure, the presence of each type of coronary risks, the value of FMD and sex (p = 0.0001). Conclusions The decrease of arterial pulsation amplitude during FMD was a useful predictive parameter for IHD. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-2794-0) contains supplementary material, which is available to authorized users.
Collapse
|