Division of Kidney and Hypertension, The Jikei University School of Medicine, Tokyo, Japan.
Clin Exp Nephrol. 2012 Aug;16(4):629-35. doi: 10.1007/s10157-012-0610-x. Epub 2012 Feb 23.
Human serum albumin is composed of human mercaptoalbumin (HMA) with cysteine residues having reducing powers and of oxidized human non-mercaptoalbumin. Previously, we reported that a lower HMA level is closely related to serious cardiovascular disease (CVD) incidence and mortality among hemodialysis patients. However, the relationship between HMA level and CVD incidence among peritoneal dialysis (PD) patients is unclear.
We measured the redox state of human serum albumin using high-performance liquid chromatography in 30 continuous ambulatory PD patients. The association between HMA and incidental CVD events was evaluated.
Eight patients experienced symptomatic CVD events (5 patients died) at the 5-year follow-up. The concentration and fraction of HMA (cHMA and f(HMA), respectively) showed significantly lower values in patients with CVD than those without CVD (cHMA 1.58 ± 0.39 and 2.16 ± 0.43 g/dL, f(HMA) 48.9 ± 5.4 and 56.4 ± 8.6%, respectively). Multiple forward stepwise regression analysis using cHMA and f(HMA) as the criterion variables was performed, and C-reactive protein and hemoglobin were adopted as significant explanatory variables in the former equation, whereas urea nitrogen was adopted in the latter equation. Multiple logistic regression analysis revealed that cHMA is a statistically, and f(HMA) is a marginally significant explanatory variable of CVD incidence (p = 0.0369, R = -0.260 and p = 0.0580, R = -0.214, respectively).
Lower HMA level, which might be caused by chronic inflammation, anemia and accumulation of dialyzable uremic toxin(s), is closely related to serious CVD incidence among PD patients.
人血清白蛋白由具有还原能力的半胱氨酸残基的人巯基白蛋白（HMA）和氧化的人非巯基白蛋白组成。以前，我们报道低 HMA 水平与血液透析患者严重心血管疾病（CVD）发病率和死亡率密切相关。然而，HMA 水平与腹膜透析（PD）患者 CVD 发病率之间的关系尚不清楚。
我们使用高效液相色谱法测量了 30 名连续流动 PD 患者的人血清白蛋白的氧化还原状态。评估 HMA 与偶然 CVD 事件之间的关联。
在 5 年随访中，8 名患者发生有症状 CVD 事件（5 名患者死亡）。与无 CVD 的患者相比，患有 CVD 的患者的 HMA 浓度和分数（cHMA 和 f（HMA））值明显降低（cHMA 为 1.58 ± 0.39 和 2.16 ± 0.43 g/dL，f（HMA）分别为 48.9 ± 5.4%和 56.4 ± 8.6%）。使用 cHMA 和 f（HMA）作为判定变量进行多元逐步向前回归分析，C-反应蛋白和血红蛋白分别被纳入前者方程的显著解释变量，而尿素氮被纳入后者方程。多元逻辑回归分析显示，cHMA 是 CVD 发病率的统计学上显著的解释变量，f（HMA）是边缘显著的解释变量（p = 0.0369，R = -0.260 和 p = 0.0580，R = -0.214，分别）。
可能由慢性炎症、贫血和可透析尿毒症毒素（s）积累引起的低 HMA 水平与 PD 患者严重 CVD 发病率密切相关。
