Atherogenic lipid profile and lipoprotein(a) in relation to serum albumin in haemodialysis patients.

Malnutrition in haemodialysis patients is associated with an increased cardiovascular mortality. Lipoprotein(a) (Lp(a)) is an independent risk factor for atherosclerotic cardiovascular disease. To evaluate the relationship between atherogenic lipid profile and serum albumin in haemodialysis patients we measured fasting serum Lp(a), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), triglyceride (TG), apoprotein A-I (ApoA-I), apoprotein B (ApoB) and albumin in 101 haemodialysis patients and in 46 healthy subjects as a control. The haemodialysis patients were divided into two groups on the basis of the level of serum albumin: group I, serum albumin < 4.0 g/dl; group II, serum albumin > or = 4.0 g/dl. Haemodialysis patients as a whole (n = 101, 17.1 mg/dl (10.3-30.9)) had higher serum Lp(a) than normal subjects (n = 46, 10.5 mg/dl (3.3-24)) (P < 0.05). Lp(a) in group I (n = 38, 27.1 mg/dl (14.6-35.0)) was significantly higher than in group II (n = 63, 14.5 mg/dl (7.7-21.7), P < 0.005) and normal subjects (P < 0.0005). However, serum Lp(a) level of group II was not different from those of normal subjects. There was a significant inverse correlation between serum Lp(a) and albumin concentration (rs = -0.26, P < 0.01). TC, TG, HDL-C, ApoA-I, ApoB, TC/HDL-C, and ApoA-I/ApoB ratios were not different between group I and group II. No correlation was found between albumin and TC, TG, HDL-C, TC/HDL-C, and ApoA-I/ApoB ratios. These results suggest that Lp(a) could be responsible for an increased cardiovascular mortality in haemodialysis patients with malnutrition.