Serum Malondialdehyde-Modified Low-Density Lipoprotein as a Risk Marker for Peripheral Arterial Stiffness in Maintenance Hemodialysis Patients
Open Access
Abstract
Background and Objectives: Peripheral arterial stiffness (PAS), assessed by brachial-ankle pulse wave velocity (baPWV), is an independent biomarker of cardiovascular diseases (CVD) in patients on maintenance hemodialysis (HD). Malondialdehyde-modified low-density lipoprotein (MDA-LDL), an oxidative stress marker, has been linked to atherosclerosis and CVD. However, the association between serum MDA-LDL and PAS among HD patients has not been fully elucidated. This study aimed to examine the association of serum MDA-LDL with PAS in HD patients and to identify the optimal cutoff value of serum MDA-LDL for predicting PAS. Materials and Methods: A cross-sectional study was conducted in 100 HD patients. Serum MDA-LDL was quantified using an enzyme-linked immunosorbent assay (ELISA), and baPWV was measured using a volume plethysmographic device. Patients were divided into the PAS group (baPWV > 18.0 m/s) and the non-PAS group (baPWV ≤ 18.0 m/s). The associations of baPWV and other clinical and biochemical parameters with serum MDA-LDL were assessed by multivariable logistic regression analyses. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff value of serum MDA-LDL for predicting PAS. Results: In multivariable logistic regression analysis, higher serum MDA-LDL, older age, and higher serum C-reactive protein [odds ratios (ORs) and 95% confidence intervals: 1.014 (1.004–1.025), 1.044 (1.004–1.085) and 3.697 (1.149–11.893)] were significantly associated with PAS. In the ROC curve analysis, the optimal cutoff value of MDA-LDL for predicting PAS was 80.91 mg/dL, with a sensitivity of 79.25% and a specificity of 59.57%. Conclusions: Greater serum MDA-LDL levels, particularly ≥80.91 mg/dL, were independently associated with PAS in HD patients. The findings suggest that oxidative stress plays a crucial role in the pathogenesis of PAS, and targeting MDA-LDL may be a potential therapeutic strategy for reducing cardiovascular risk in HD patients.Keywords
Funding Information
- Hualien Armed Forces General Hospital, Hualien, Taiwan (HAFGH-D-112013)
This publication has 57 references indexed in Scilit:
- Lipid Peroxidation in Atherosclerotic Cardiovascular DiseasesAntioxidants & Redox Signaling, 2020
- Angiotensin II and leukocyte trafficking: New insights for an old vascular mediator. Role of redox-signaling pathwaysFree Radical Biology and Medicine, 2020
- Vaccination against atherosclerosis: An overviewHellenic Journal of Cardiology, 2020
- Oxidized low density lipoproteins: The bridge between atherosclerosis and autoimmunity. Possible implications in accelerated atherosclerosis and for immune intervention in autoimmune rheumatic disordersAutoimmunity Reviews, 2018
- Arterial stiffness as a risk factor for clinical hypertensionNature Reviews Cardiology, 2017
- Optimal Target Level of Low-density Lipoprotein Cholesterol for Vascular Function in Statin Naïve IndividualsScientific Reports, 2017
- Circulating malondialdehyde-modified low-density lipoprotein (MDA-LDL) as a novel predictor of clinical outcome after endovascular therapy in patients with peripheral artery disease (PAD)Atherosclerosis, 2017
- Do Advanced Glycation End Products and Its Receptor Play a Role in Pathophysiology of Hypertension?International Journal of Angiology, 2017
- The next generation of therapeutics for chronic kidney diseaseNature Reviews Drug Discovery, 2016
- Modified low-density lipoprotein may moderate the association of baseline hs-CRP with incident cardiac events in the Asian populationsJournal of Cardiology, 2016