Abstract: SA-PO190
HDL Subclasses Alter with CKD Progression and Are Associated with ABI and Klotho Level in CKD-Stage-Specific Manner
Session Information
- Nutrition, Inflammation, Metabolism: Clinical Trials, Biomarkers, Epidemiology
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Nutrition, Inflammation, and Metabolism
- 1401 Nutrition, Inflammation, Metabolism
Authors
- Kanda, Eiichiro, Tokyo Kyosai Hospital, Meguro, TOKYO, Japan
- Maeda, Yoshitaka, JA Toride Medical Center, Ibaraki, Japan
Background
Atherosclerosis is a complication of chronic kidney disease (CKD). Lipoprotein subclasses consist of a continuous spectrum of particles of different sizes and densities, and high-density lipoproteins (HDLs) are grouped into various subclasses (Table 1). We investigated the roles of lipoprotein subclasses in atherosclerosis and CKD-mineral and bone disorder.
Methods
Seventy one CKD patients (male, 70.4%; diabetic nephropathy, 23.9%) were enrolled in this prospective cohort study in Japan. The proportion of cholesterol level to total cholesterol level and the lipoprotein particle number in 20 lipoprotein fractions were measured by a newly developed method of high-performance gel permeation chromatography (HGPC).
Results
The average age (SD) was 75.0 (11.1) years and the estimated glomerular filtration rate (eGFR) was 17.2 (8.3) ml/min/1.73m2. Although no statistically significant difference in cholesterol levels in lipoproteins or triglyceride levels between CKD stages 4 and 5 was shown by HGPC, the method showed that the lipoprotein particle number in small HDLs was higher in Stage 4 than in Stage 5 (p=0.002). Multivariate regression analysis adjusted for baseline characteristics showed that the cholesterol proportion in very small HDLs was negatively associated with eGFR change rate [fraction (F) 19 β=-17.63, p=0.036] and was associated with ABI [F19 β= 0.047, p=0.047] in Stage 4. Moreover, serum soluble α-Klotho level was associated with the number of very small HDL particles [F19 β=0.00026, p=0.012; F20 β=0.00041, p=0.036] in Stage 5.
Conclusion
This study showed that HDL subclasses alter with CKD progression and are associated with ABI and Klotho level in a CKD-stage-specific manner.
Definitions of classes and subclasses of lipoproteins
Fraction | F1-2 | F3-5 | F6 | F7 | F8 | F9 | F10 | F11-13 | F14-15 | F16 | F17 | F18 | F19-20 |
Subclass | CM | Large VLDL | Medium VLDL | Small VLDL | Large LDL | Medium LDL | Small LDL | Very small LDL | Very large HDL | Large HDL | Medium HDL | Small HDL | Very small HDL |