Novel lipoprotein subfraction and size measurements in prediction of mortality in maintenance hemodialysis patients

Nazanin Noori, Michael P. Caulfield, Wael A. Salameh, Richard E. Reitz, Susanne B. Nicholas, Miklos Z. Molnar, Allen R. Nissenson, Csaba Kovesdy, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

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Abstract

Background and objectives Conventional lipid profiles usually cannot predict cardiovascular outcomes in chronic disease states. We hypothesized that novel lipoprotein subfraction concentrations and LDL particle size measurements better predict mortality in maintenance hemodialysis (MHD) patients. Design, setting, participants, & measurements Mortality-predictability of LDL particle diameter and lipoprotein subfraction concentrations, measured by novel ion mobility, was examined in a cohort of 235 hemodialysis patients who were followed for up to 6 years using Cox models with adjustment for important covariables. Results Patients were 54 ± 14 years old (mean ± SD) and included 45% women with total, LDL and HDL cholesterol levels of 143 ± 42, 76 ± 29, and 37 ± 12 mg/dl, respectively. Over 6 years, 71 patients (31%) died. Conventional lipid profile was not associated with mortality. The death hazard ratio (HR, 95% confidence interval) of the highest versus lowest quartiles of very small and large LDL particle concentrations were 2.43 (1.03 to 5.72) and 0.38 (0.15 to 0.96), respectively. Across increasing quartiles of LDL particle diameter, death HRs were 1.00, 0.93 (0.46 to 1.87), 0.43 (0.21 to 0.89), and 0.45 (0.31 to 1.00), respectively. Conclusions Whereas conventional lipid profile cannot predict mortality in MHD patients, larger novel LDL particle diameter or higher large LDL particle concentrations appear predictive of greater survival, whereas higher very small LDL particle concentration is associated with higher death risk. Examining lipoprotein subfraction modulation in chronic diseases is indicated.

Original languageEnglish (US)
Pages (from-to)2861-2870
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number12
DOIs
StatePublished - Dec 1 2011

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Lipoproteins
Renal Dialysis
Maintenance
Mortality
Lipids
Chronic Disease
oxidized low density lipoprotein
Proportional Hazards Models
Particle Size
LDL Cholesterol
HDL Cholesterol
Confidence Intervals
Ions
Survival

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Noori, N., Caulfield, M. P., Salameh, W. A., Reitz, R. E., Nicholas, S. B., Molnar, M. Z., ... Kalantar-Zadeh, K. (2011). Novel lipoprotein subfraction and size measurements in prediction of mortality in maintenance hemodialysis patients. Clinical Journal of the American Society of Nephrology, 6(12), 2861-2870. https://doi.org/10.2215/CJN.03650411

Novel lipoprotein subfraction and size measurements in prediction of mortality in maintenance hemodialysis patients. / Noori, Nazanin; Caulfield, Michael P.; Salameh, Wael A.; Reitz, Richard E.; Nicholas, Susanne B.; Molnar, Miklos Z.; Nissenson, Allen R.; Kovesdy, Csaba; Kalantar-Zadeh, Kamyar.

In: Clinical Journal of the American Society of Nephrology, Vol. 6, No. 12, 01.12.2011, p. 2861-2870.

Research output: Contribution to journalArticle

Noori, N, Caulfield, MP, Salameh, WA, Reitz, RE, Nicholas, SB, Molnar, MZ, Nissenson, AR, Kovesdy, C & Kalantar-Zadeh, K 2011, 'Novel lipoprotein subfraction and size measurements in prediction of mortality in maintenance hemodialysis patients', Clinical Journal of the American Society of Nephrology, vol. 6, no. 12, pp. 2861-2870. https://doi.org/10.2215/CJN.03650411
Noori, Nazanin ; Caulfield, Michael P. ; Salameh, Wael A. ; Reitz, Richard E. ; Nicholas, Susanne B. ; Molnar, Miklos Z. ; Nissenson, Allen R. ; Kovesdy, Csaba ; Kalantar-Zadeh, Kamyar. / Novel lipoprotein subfraction and size measurements in prediction of mortality in maintenance hemodialysis patients. In: Clinical Journal of the American Society of Nephrology. 2011 ; Vol. 6, No. 12. pp. 2861-2870.
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N2 - Background and objectives Conventional lipid profiles usually cannot predict cardiovascular outcomes in chronic disease states. We hypothesized that novel lipoprotein subfraction concentrations and LDL particle size measurements better predict mortality in maintenance hemodialysis (MHD) patients. Design, setting, participants, & measurements Mortality-predictability of LDL particle diameter and lipoprotein subfraction concentrations, measured by novel ion mobility, was examined in a cohort of 235 hemodialysis patients who were followed for up to 6 years using Cox models with adjustment for important covariables. Results Patients were 54 ± 14 years old (mean ± SD) and included 45% women with total, LDL and HDL cholesterol levels of 143 ± 42, 76 ± 29, and 37 ± 12 mg/dl, respectively. Over 6 years, 71 patients (31%) died. Conventional lipid profile was not associated with mortality. The death hazard ratio (HR, 95% confidence interval) of the highest versus lowest quartiles of very small and large LDL particle concentrations were 2.43 (1.03 to 5.72) and 0.38 (0.15 to 0.96), respectively. Across increasing quartiles of LDL particle diameter, death HRs were 1.00, 0.93 (0.46 to 1.87), 0.43 (0.21 to 0.89), and 0.45 (0.31 to 1.00), respectively. Conclusions Whereas conventional lipid profile cannot predict mortality in MHD patients, larger novel LDL particle diameter or higher large LDL particle concentrations appear predictive of greater survival, whereas higher very small LDL particle concentration is associated with higher death risk. Examining lipoprotein subfraction modulation in chronic diseases is indicated.

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