- Email: [email protected]
332: Impact of nutritional advice on dyslipidemia and lipid peroxidation in chronic renal failure patients
Journal of Clinical Lipidology, Vol 2, No 5S, October 2008
levels significantly predicted vascular events in our cohort of angiographied men after adjustment for age, BMI, hypertension, diabetes, LDL-C, HDL-C, and smoking (standardized adjusted HR = 0.808 [0.673 – 0.971]; p = 0.023). Importantly, also a decrease in kidney function from baseline to the follow-up visit at 2 years later significantly predicted vascular events in the following 4 years independently from the baseline eGFR (standardized adjusted HR = 1.472 [1.162 – 1.865]; p = 0.001). Conclusions: Independently of the baseline eGFR a decrease in eGFR over two years strongly and significantly predicts vascular events over the consequent 4 years in men undergoing coronary angiography.
role of age and age-less CIn [aCIn], as proxy of CV disease. aCIn (OR 0.6;CI 0.4-0.9;p=0.008) at 2-y; aCIn (OR 0.6;CI 0.4-0.9;p=0.021) and age (OR 0.93;CI 0.88-0.97;p=0.003) at 5-y; age (OR 0.95;CI 0.90-0.99;p=0.007) at 9-y were significant determinants of survival. Conclusions: Our study suggests that in HD pts only short-term survival is determined by modifiable factors (access, Kt/V). Non modifiable factors (age, aCIn, HD vintage) were also significant determinants of survival, lower CV comorbidities being associated with short- and mid-term, and younger age with midand long-term survival. Funding: none
Funding: none 332
DETERMINANTS OF SHORT- AND LONG-TERM SURVIVAL IN PREVALENT HEMODIALYSIS PATIENTS W. Mantovani1, V. Bedogna2, S. Tardivo1, A. Poli1, N. Tessitore2. 1Department of Public Health, University of Verona, Verona, Italy, 2Division of Nephrology, University of Verona, Verona, Italy
IMPACT OF NUTRITIONAL ADVICE ON DYSLIPIDEMIA AND LIPID PEROXIDATION IN CHRONIC RENAL FAILURE PATIENTS K. Mekki1, A. Boukaddoum1, N. Bekada-Bouzidi1, A. Kaddous2, M. Bouchenak1. 1Laboratoire de Nutrition Clinique et Métabolique. Faculté des Sciences,Université Es Sénia, Oran, Algeria, 2Service de Néphrologie. CHU Oran, Oran, Algeria
Objectives: Many clinical and laboratory parameters have been associated with survival in hemodialysis [HD] subjects [pts], but their role is still unclear. Aim of our study was to evaluate prospectively the relative role of Charlson Index [CIn], blood pressure [BP], smoking, HD vintage, Kt/V and 38 biochemical risk factors of cardiovascular [CV] mortality in determining survival in prevalent HD pts. Methods: 90 pts (41 M, age 64±15 y, HD vintage 5.5±6 y; 77 with fistula (F), 5 with graft, 8 with permanent catheter as vascular access) were followed up for 9 y. Results: 62 pts died (32 for CV disease) and 28 survived. Using survival as outcome in logistic regression, F (OR 14.9;95%CI 2.7-81.2;p=0.002), Kt/V>1.2 (OR 4.9;CI 1.4-16.4;p=0.011), CIn (OR 0.6;CI 0.4-0.8;p=0.002) were significant determinants at 2-y; HD vintage (OR 0.9;CI 0.80.9;p=0.032) and CIn (OR 0.5;CI 0.30.7;p<0.0001) at 5-y; CIn (OR 0.5;CI 0.30.7;p<0.0001) at 9-y. Since age and CV disease are the main factors of CIn in HD pts, we assessed the
Objective: To evaluate the impact of dietary advice on dyslipidemia, lipid peroxidation and inflammation markers in chronic renal failure (CRF) patients. Methods: Among 80 CRF patients (58±9 years) detected in the university hospital of Oran, 40 patients with hypertriglyceridemia (TG> 1.7 mmol/L) and/or hypercholesterolemia (TC> 5mmol/L) were recruited for the study. Patients received nutritional councils adapted to CRF. A 7 day food recall and record were obtained at baseline, and at one month. Blood samples were drawn at the initiating study (T0) and 30 d (T1), 60 d (T2) and 90 d (T3) after. Results: Similar energy and protein intakes were noted at T1 compared to T0. Low simple carbohydrates, high MUFA intakes and low consumption of dairy products and fat (butter, oils and margarine) were noted at T1 compared to T0 (P<0,05).Compared to T0, a chronological decrease in TG values by 39%, 41% and 60% was noted at T1, T2 and T3. TC lowered at T3 (P<0.05), HDL-C, LDL-C and apo A-I were unchanged, whereas apo B values decreased by
331
S155
Multiple Risk Factors in Cardiovascular Disease—Abstracts
26% at T2. Decrease in TC/ HDL-C (29%) and TC/ LDL-C (32%) ratios were noted at T3. Apo A-I/apo B ratio increased by 25%, 51% and 27% at T1, T2 and T3. Thiobarbituric acid reactive substances (TBARS) were lowered at T3,. Albumin concentrations and reactive protein C rate did not vary according to nutritional intervention. Conclusions: Advice to CRF patients to follow a healthy diet has lasting effects on cardiovascular risk profile.
did not alter homocysteine levels after 3 months intervention compared to placebo (-0.3 ± 7.8 vs 0.3 ± 7.1, p=0.58). Treatment significantly increased the content of n-3 PUFA in serum phospholipids (p<0.001). Conclusions: Despite of hyperhomocysteinaemia, supplementation with n3 PUFA does not change homocysteine levels in patient on HD. Fundings: This study was kindly supported by Pronova Biocare and the Danish Heart Association
Funding: Projet ANDRS N° 02/15/01/01/084
333
334
THE EFFECT OF N-3 FATTY ACIDS ON HOMOCYSTEINE LEVELS IN HYPERHOMOCYSTEINAEMIC PATIENTS UNDERGOING CHRONIC HEMODIALYSIS L. Rasmussen1, M. Svensson1, E.B. Schmidt2, J.H. Christensen1. 1Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark, 2Center for Cardiovascular Research, Aalborg University Hospital, Aalborg, Denmark
THE EFFECT OF ZINC SUPPLEMENTATION ON PARAOXONASE ACTIVITY IN HEMODIALYSIS PATIENTS A. Ghorbanihaghjo1, N. Rashtchizadeh2, H. Argani1, M. Rohbaninoubar1, J. Safa, A. Vatankhah, B. Rahimi. 1Drug Applied Research Center, Tabriz University of Medical Sciences, Medical Faculty, Tabriz, Iran, 2Biotechnology Research Center, Tabriz University of Medical Sciences, Medical Faculty, Tabriz, Iran.
Objective: Patients on haemodialysis (HD) have a high morbidity and mortality from cardiovascular disease (CVD). An elevated homocysteine level is an independent predictor of cardiovascular events in this patient group. The group of n-3 polyunsaturated fatty acids (n-3 PUFA) has a broad range of beneficial effects on cardiovascular risk factors. Interestingly, some studies have found an inverse relationship between the content of n-3 PUFA and homocysteine levels, but the evidence is ambiguous. The objective of this study was to investigate, if supplementation with n-3 PUFA changes homocysteine levels in patients on HD. Methods: In a double-blind randomized placebo controlled design 206 patients, with documented CVD and treated with HD for a minimum of 6 months, were randomized to treatment with either daily supplement of 1.7 g n-3 PUFA or placebo (olive oil). The content of n-3 PUFA in serum phospholipids and homocysteine levels in plasma were measured at baseline and after 3 months of intervention. Results: The content of homocysteine in plasma was elevated in both treatment groups at baseline (26.8 ± 13.4 vs 28.41 ± 13.3, p=0.65). Supplementation with n-3 PUFA
Objective: The study was designed to determine the antioxidant effect of zinc sulfate supplementation on serum levels of Cholesterol (Cho),Triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I (apoA-I), apolipoprotein B (Apo B) concentrations and paraoxonase (PON) activity in stable hemodialysis patients (HD). Methods: Thirty hemodialysis patients were treated with 100 mg/day zinc sulfate for 2 months. HDL-C, TG, Cholesterol, LDL-C, Apo-AI, Apo B concentrations and PON activity in serum were measured before and after the treatment. Serum Lipid and lipoproteins concentrations were measured by standard enzymatic methods, Apo-AI and Apo B levels were determined by immunoturbidimetric assay and PON activity was measured spectrophotometrically using paraoxon substrate. Results: After the treatment, an elevation in the serum levels of Apo-AI (88.6 + 12.4 vs. 91.9 + 13.1mg/dl, P<0.04), concentration of HDL-C (33.5 + 4.1 vs.34.5 + 3.9 mg/dl, P=0.005), and PON activity (83.3 + 13.4 vs. 86.9 + 12.1 IU/L, P=0.003) were found. While the LDL-C (88.7 + 26.1 vs. 87.4 + 26.4 mg/dl, p> 0.4), Cho (152.7 + 31.9 vs. 152.6 + 31.6 mg/dl, p> 0.8), TG (137.5 +
S156
levels significantly predicted vascular events in our cohort of angiographied men after adjustment for age, BMI, hypertension, diabetes, LDL-C, HDL-C, and smoking (standardized adjusted HR = 0.808 [0.673 – 0.971]; p = 0.023). Importantly, also a decrease in kidney function from baseline to the follow-up visit at 2 years later significantly predicted vascular events in the following 4 years independently from the baseline eGFR (standardized adjusted HR = 1.472 [1.162 – 1.865]; p = 0.001). Conclusions: Independently of the baseline eGFR a decrease in eGFR over two years strongly and significantly predicts vascular events over the consequent 4 years in men undergoing coronary angiography.
role of age and age-less CIn [aCIn], as proxy of CV disease. aCIn (OR 0.6;CI 0.4-0.9;p=0.008) at 2-y; aCIn (OR 0.6;CI 0.4-0.9;p=0.021) and age (OR 0.93;CI 0.88-0.97;p=0.003) at 5-y; age (OR 0.95;CI 0.90-0.99;p=0.007) at 9-y were significant determinants of survival. Conclusions: Our study suggests that in HD pts only short-term survival is determined by modifiable factors (access, Kt/V). Non modifiable factors (age, aCIn, HD vintage) were also significant determinants of survival, lower CV comorbidities being associated with short- and mid-term, and younger age with midand long-term survival. Funding: none
Funding: none 332
DETERMINANTS OF SHORT- AND LONG-TERM SURVIVAL IN PREVALENT HEMODIALYSIS PATIENTS W. Mantovani1, V. Bedogna2, S. Tardivo1, A. Poli1, N. Tessitore2. 1Department of Public Health, University of Verona, Verona, Italy, 2Division of Nephrology, University of Verona, Verona, Italy
IMPACT OF NUTRITIONAL ADVICE ON DYSLIPIDEMIA AND LIPID PEROXIDATION IN CHRONIC RENAL FAILURE PATIENTS K. Mekki1, A. Boukaddoum1, N. Bekada-Bouzidi1, A. Kaddous2, M. Bouchenak1. 1Laboratoire de Nutrition Clinique et Métabolique. Faculté des Sciences,Université Es Sénia, Oran, Algeria, 2Service de Néphrologie. CHU Oran, Oran, Algeria
Objectives: Many clinical and laboratory parameters have been associated with survival in hemodialysis [HD] subjects [pts], but their role is still unclear. Aim of our study was to evaluate prospectively the relative role of Charlson Index [CIn], blood pressure [BP], smoking, HD vintage, Kt/V and 38 biochemical risk factors of cardiovascular [CV] mortality in determining survival in prevalent HD pts. Methods: 90 pts (41 M, age 64±15 y, HD vintage 5.5±6 y; 77 with fistula (F), 5 with graft, 8 with permanent catheter as vascular access) were followed up for 9 y. Results: 62 pts died (32 for CV disease) and 28 survived. Using survival as outcome in logistic regression, F (OR 14.9;95%CI 2.7-81.2;p=0.002), Kt/V>1.2 (OR 4.9;CI 1.4-16.4;p=0.011), CIn (OR 0.6;CI 0.4-0.8;p=0.002) were significant determinants at 2-y; HD vintage (OR 0.9;CI 0.80.9;p=0.032) and CIn (OR 0.5;CI 0.30.7;p<0.0001) at 5-y; CIn (OR 0.5;CI 0.30.7;p<0.0001) at 9-y. Since age and CV disease are the main factors of CIn in HD pts, we assessed the
Objective: To evaluate the impact of dietary advice on dyslipidemia, lipid peroxidation and inflammation markers in chronic renal failure (CRF) patients. Methods: Among 80 CRF patients (58±9 years) detected in the university hospital of Oran, 40 patients with hypertriglyceridemia (TG> 1.7 mmol/L) and/or hypercholesterolemia (TC> 5mmol/L) were recruited for the study. Patients received nutritional councils adapted to CRF. A 7 day food recall and record were obtained at baseline, and at one month. Blood samples were drawn at the initiating study (T0) and 30 d (T1), 60 d (T2) and 90 d (T3) after. Results: Similar energy and protein intakes were noted at T1 compared to T0. Low simple carbohydrates, high MUFA intakes and low consumption of dairy products and fat (butter, oils and margarine) were noted at T1 compared to T0 (P<0,05).Compared to T0, a chronological decrease in TG values by 39%, 41% and 60% was noted at T1, T2 and T3. TC lowered at T3 (P<0.05), HDL-C, LDL-C and apo A-I were unchanged, whereas apo B values decreased by
331
S155
Multiple Risk Factors in Cardiovascular Disease—Abstracts
26% at T2. Decrease in TC/ HDL-C (29%) and TC/ LDL-C (32%) ratios were noted at T3. Apo A-I/apo B ratio increased by 25%, 51% and 27% at T1, T2 and T3. Thiobarbituric acid reactive substances (TBARS) were lowered at T3,. Albumin concentrations and reactive protein C rate did not vary according to nutritional intervention. Conclusions: Advice to CRF patients to follow a healthy diet has lasting effects on cardiovascular risk profile.
did not alter homocysteine levels after 3 months intervention compared to placebo (-0.3 ± 7.8 vs 0.3 ± 7.1, p=0.58). Treatment significantly increased the content of n-3 PUFA in serum phospholipids (p<0.001). Conclusions: Despite of hyperhomocysteinaemia, supplementation with n3 PUFA does not change homocysteine levels in patient on HD. Fundings: This study was kindly supported by Pronova Biocare and the Danish Heart Association
Funding: Projet ANDRS N° 02/15/01/01/084
333
334
THE EFFECT OF N-3 FATTY ACIDS ON HOMOCYSTEINE LEVELS IN HYPERHOMOCYSTEINAEMIC PATIENTS UNDERGOING CHRONIC HEMODIALYSIS L. Rasmussen1, M. Svensson1, E.B. Schmidt2, J.H. Christensen1. 1Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark, 2Center for Cardiovascular Research, Aalborg University Hospital, Aalborg, Denmark
THE EFFECT OF ZINC SUPPLEMENTATION ON PARAOXONASE ACTIVITY IN HEMODIALYSIS PATIENTS A. Ghorbanihaghjo1, N. Rashtchizadeh2, H. Argani1, M. Rohbaninoubar1, J. Safa, A. Vatankhah, B. Rahimi. 1Drug Applied Research Center, Tabriz University of Medical Sciences, Medical Faculty, Tabriz, Iran, 2Biotechnology Research Center, Tabriz University of Medical Sciences, Medical Faculty, Tabriz, Iran.
Objective: Patients on haemodialysis (HD) have a high morbidity and mortality from cardiovascular disease (CVD). An elevated homocysteine level is an independent predictor of cardiovascular events in this patient group. The group of n-3 polyunsaturated fatty acids (n-3 PUFA) has a broad range of beneficial effects on cardiovascular risk factors. Interestingly, some studies have found an inverse relationship between the content of n-3 PUFA and homocysteine levels, but the evidence is ambiguous. The objective of this study was to investigate, if supplementation with n-3 PUFA changes homocysteine levels in patients on HD. Methods: In a double-blind randomized placebo controlled design 206 patients, with documented CVD and treated with HD for a minimum of 6 months, were randomized to treatment with either daily supplement of 1.7 g n-3 PUFA or placebo (olive oil). The content of n-3 PUFA in serum phospholipids and homocysteine levels in plasma were measured at baseline and after 3 months of intervention. Results: The content of homocysteine in plasma was elevated in both treatment groups at baseline (26.8 ± 13.4 vs 28.41 ± 13.3, p=0.65). Supplementation with n-3 PUFA
Objective: The study was designed to determine the antioxidant effect of zinc sulfate supplementation on serum levels of Cholesterol (Cho),Triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I (apoA-I), apolipoprotein B (Apo B) concentrations and paraoxonase (PON) activity in stable hemodialysis patients (HD). Methods: Thirty hemodialysis patients were treated with 100 mg/day zinc sulfate for 2 months. HDL-C, TG, Cholesterol, LDL-C, Apo-AI, Apo B concentrations and PON activity in serum were measured before and after the treatment. Serum Lipid and lipoproteins concentrations were measured by standard enzymatic methods, Apo-AI and Apo B levels were determined by immunoturbidimetric assay and PON activity was measured spectrophotometrically using paraoxon substrate. Results: After the treatment, an elevation in the serum levels of Apo-AI (88.6 + 12.4 vs. 91.9 + 13.1mg/dl, P<0.04), concentration of HDL-C (33.5 + 4.1 vs.34.5 + 3.9 mg/dl, P=0.005), and PON activity (83.3 + 13.4 vs. 86.9 + 12.1 IU/L, P=0.003) were found. While the LDL-C (88.7 + 26.1 vs. 87.4 + 26.4 mg/dl, p> 0.4), Cho (152.7 + 31.9 vs. 152.6 + 31.6 mg/dl, p> 0.8), TG (137.5 +
S156