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Decreased high‐density lipoprotein cholesterol is associated with inflammation and insulin resistance in non‐diabetic haemodialysis patients
Author(s) -
PENG YUSEN,
CHIU YENLING,
CHEN HUNGYUAN,
YANG JUYEH,
LAI CHUNFU,
HSU SHIHPING,
PAI MEIFEN
Publication year - 2010
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2010.01295.x
Subject(s) - medicine , insulin resistance , endocrinology , adiponectin , triglyceride , body mass index , high density lipoprotein , population , diabetes mellitus , insulin , lipoprotein , cholesterol , environmental health
Aim: Lower serum high‐density lipoprotein cholesterol (HDL‐C) is associated with inflammation, insulin resistance and poor cardiovascular outcomes in the general population. However, in a large‐scale study, the association between HDL and survival in haemodialysis patients was not present. The exact cause of lack of HDL‐C protection in the dialysis population is still obscure. Methods: A total of 89 stable non‐diabetic haemodialysis patients were recruited. Fasting serum biochemical parameters, complete blood counts and inflammatory markers were obtained before the mid‐week dialysis. Insulin resistance was assessed by the Homeostasis Model Assessment of Insulin Resistance (HOMA‐IR). Results: The mean age was 58.2 ± 13.1 years, 37 (41.6%) patients were male. The mean HDL‐C level was 56.3 ± 17.1 mg/dL. By bivariate correlation analysis, a lower serum HDL‐C level was related to higher body mass index ( r = −0.425; P < 0.001), higher triglyceride ( r = −0.479; P < 0.001) and higher HOMA‐IR ( r = −0.211; P < 0.05) levels. The serum HDL‐C level was also inversely related to high‐sensitivity C‐reactive protein (hsCRP) ( r = −0.297; P = 0.005) and tumour necrosis factor‐α (TNF‐α) ( r = −0.295; P = 0.005) and directly correlated with adiponectin ( r = 0.560; P < 0.001). In multivariate linear regression analysis, HDL‐C was found to be directly correlated with adiponectin (β‐coefficient = 0.569; P < 0.001) and inversely correlated with TNF‐α (β‐coefficient = −0.292; P = 0.001). Conclusion: A strong association between HDL‐C, inflammatory surrogates, and insulin resistance in this non‐diabetic, non‐obese haemodialysis patient group is demonstrated. The HDL‐C level is still a good parameter to screen high‐risk patients.