Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
J Med Food. 2010 Dec;13(6):1490-3. doi: 10.1089/jmf.2010.1074.
Although hemodialysis (HD) is essential for end-stage renal disease patients, at the same time it causes oxidative stress and long-term pro-atherosclerotic effects. This study aimed to determine lipid profile as well as the total antioxidant capacity (TAC) and vitamins A, E, and C in HD patients. The study enrolled 31 patients (50.3 ± 14.9 years old) undergoing maintenance 4-hour HD three times per week with a polysulfone membrane dialyzer for a mean of 76.1 months (range, 7-120 months) and 31 healthy individuals (47.8 ± 13.9 years old). Lipid profiles were determined spectrophotometrically using commercially available kits. Total antioxidant capacity was determined by ferric reducing/antioxidant power assay, levels of vitamins A and E were assayed using high-pressure liquid chromatography, and the level of vitamin C was measured by a photometric method. Our results showed that before HD, the levels of TAC and vitamin A were significantly higher than in normal subjects, whereas the levels of high-density lipoprotein (HDL) and vitamin C were lower than in control subjects (P < .001). There was no significant difference between normal subjects and patients before dialysis regarding low-density lipoprotein (LDL) and vitamin E levels (P > .05). After HD, the levels of HDL-cholesterol, vitamins E and C, and TAC decreased significantly (P < .001), but the decreased level of vitamin A still remained higher than controls (P < .05), whereas the levels of LDL were significantly higher than controls (P < .001). In conclusion, alterations in the lipoprotein profiles and antioxidant markers following HD suggest an increased risk of atherosclerosis in these patients.
虽然血液透析(HD)对终末期肾病患者至关重要,但同时它也会引起氧化应激和长期的动脉粥样硬化作用。本研究旨在确定血液透析患者的血脂谱以及总抗氧化能力(TAC)和维生素 A、E、C 的水平。该研究纳入了 31 名患者(50.3±14.9 岁),他们使用聚砜膜透析器每周进行 3 次 4 小时的维持性血液透析,平均透析时间为 76.1 个月(7-120 个月),并纳入了 31 名健康对照者(47.8±13.9 岁)。使用商业试剂盒通过分光光度法测定血脂谱。通过铁还原/抗氧化能力测定法测定总抗氧化能力,使用高效液相色谱法测定维生素 A 和 E 的水平,通过光比色法测定维生素 C 的水平。结果显示,在血液透析前,TAC 和维生素 A 的水平明显高于对照组,而高密度脂蛋白(HDL)和维生素 C 的水平则低于对照组(P<0.001)。在透析前,对照组与患者之间的 LDL 和维生素 E 水平无显著差异(P>0.05)。血液透析后,HDL-胆固醇、维生素 E 和 C 以及 TAC 的水平显著降低(P<0.001),但维生素 A 的降低水平仍高于对照组(P<0.05),而 LDL 的水平则明显高于对照组(P<0.001)。总之,血液透析后脂蛋白谱和抗氧化标志物的改变表明这些患者发生动脉粥样硬化的风险增加。