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Kidney Week

Abstract: FR-PO557

Lipoprotein Subfraction Analyses in a Cohort of the Palm Tocotrienols in Chronic Hemodialysis Study (PATCH)

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Latifi, Eno, Wayne State University, Detroit, Michigan, United States
  • Tallman, Dina A., Wayne State University, Detroit, Michigan, United States
  • Kaur, Deepinder, Wayne State University, Detroit, Michigan, United States
  • Khosla, Pramod, Wayne State University, Detroit, Michigan, United States

Group or Team Name

  • The PATCH Investigators
Background

Dyslipidemia (D) is one of the characteristics of end-stage renal disease patients who develop cardiovascular disease (CVD). The PATCH clinical trials [NCT02358967, NCT02913690] are double-blind one-year intervention trials (300 mg tocotrienols or placebo daily) in hemodialysis patients in USA, Malaysia and Bangladesh (currently some 400 patients are enrolled). A pilot study showed improvement in D with tocotrienols. The aim of this preliminary analysis is to evaluate and characterize lipoprotein subfractions in the PATCH Michigan cohort.

Methods

The Michigan cohort includes 138 patients enrolled across various dialysis clinics in Michigan (recruitment ends Dec 2018). Subject are 95% African Americans (Age 59 ± 13 yrs., 64% men, dialysis vintage 65±63 months). Blood was collected at baseline and plasma isolated for lipid determination and lipoprotein subfraction analyses using a gel-electrophoresis method (Quantimetrix LipoprintTM).

Results

Baseline plasma lipids (n=124) revealed HDL-C, LDL-C and Triglyceride (TAG) values (mg/dL) of 49±18, 79±39 and 95±51, respectively. The values were not influenced by the dialysis shift during blood collection. The percentage of large, intermediate and small HDL particles were 39.4±15.6, 46.9±9.5 and 13.6±8.4, respectively. The percentage of large, intermediate and small LDL particles were 15.0±4.3, 8.1±3.9 and 2.4±3.3, respectively. Eight percent of subjects were D (TAG 201±54, HDL-C 33±5, LDL-C 133±17 mg/dL), 48% were normolipemic [N] (TAG 64±25, HDL-C 61±18, LDL-C 55±23 mg/dL), while the rest had mixed D (TAG 110±36, HDL-C 40±11, LDL-C 96±38 mg/dL). Dyslipidemic subjects had significantly greater proportion of small HDL particles than N subjects (22.5%±4.5% vs 9.1%±6.9%), while large HDL (24.6%±8.9% vs 48.3%±13.9%) and intermediate HDL (52.9%±6.6% vs 42.4%±8.7%) were significantly lower. D subjects had significantly smaller LDL particle sizes compared to N subjects.

Conclusion

Changes in circulating lipoproteins reflect alterations in LDL and HDL particle sizes that can be readily detected. The role of these compositional changes in CVD in HDL patients is as yet, unresolved. (Supported by the Malaysian Palm Oil Board/Government of Malaysia)