Cholesterol Synthesis, Cholesterol Absorption, and Mortality in Hemodialysis Patients
| Autor: | Kyrill S. Rogacev, Gunnar H. Heine, Oliver Weingärtner, Markus K. Gerhart, Danilo Fliser, Tobias Pinsdorf, Kai van Bentum, Julius Popp, Andreas Menzner, Elena Welzel, Dieter Lütjohann |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Chromatography Gas Time Factors Epidemiology medicine.medical_treatment Lathosterol Kaplan-Meier Estimate Critical Care and Intensive Care Medicine Risk Assessment Gastroenterology Intestinal absorption chemistry.chemical_compound Renal Dialysis Risk Factors Germany Internal medicine medicine Humans Aged Proportional Hazards Models Aged 80 and over Transplantation business.industry Cholesterol Proportional hazards model Cholestanol Hazard ratio Middle Aged Confidence interval Treatment Outcome Endocrinology Intestinal Absorption chemistry Nephrology Case-Control Studies Chronic Disease Multivariate Analysis Female Kidney Diseases Hemodialysis business Biomarkers Follow-Up Studies |
| Zdroj: | Clinical Journal of the American Society of Nephrology. 7:943-948 |
| ISSN: | 1555-9041 |
| Popis: | Summary Background and objectives Recent clinical trials on cholesterol-lowering in patients with CKD yielded conflicting results, which might have resulted from different treatment strategies. Serum cholesterol levels are determined by endogenous synthesis and intestinal absorption, which are differentially influenced by various classes of cholesterol-lowering agents. Assessing markers of cholesterol metabolism has thus been proposed for guidance of lipid-lowering therapy. This study analyzed surrogate markers of cholesterol absorption and synthesis in hemodialysis (HD) patients. Design, setting, participants, & measurements In 113 HD patients, lathosterol was measured as a marker of cholesterol synthesis and cholestanol was measured as a marker of cholesterol absorption via gas chromatography. Controls were 229 healthy persons. Overall survival in HD patients was recorded over 3.4-year follow-up. Results Compared with controls, HD patients had lower lathosterol and higher cholestanol levels (P,0.001 for both).Duringfollow-up,58patients died;highercholestanol(indicatinghighercholesterolabsorption)predicted poor outcome among HD patients in multivariate Cox regression analysis after adjustment for potential confounders (hazard ratio for cholestanol above median, 2.24 [95% confidence interval (CI), 1.29–3.89]; P=0.004), whereas lower lathosterol (indicating lower cholesterol synthesis) did not (hazard ratio for lathosterol below median, 1.43 [95% CI, 0.81–2.50]; P=0.22). Conclusions This analysis of markers of cholesterol metabolism characterizes HD patients as cholesterol absorbers. In longitudinal analysis, higher levels of cholestanol were associated with all-cause mortality. Clin J Am Soc Nephrol 7: 943–948, 2012. doi: 10.2215/CJN.05170511 |
| Databáze: | OpenAIRE |
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