Effect of low-density lipoprotein apheresis on plasma endothelin-1 levels in diabetic hemodialysis patients with arteriosclerosis obliterans.

Abstract

Endothelin (ET)-1 has been implicated in the pathogenesis of diabetes, arteriosclerosis, and chronic renal failure. We studied whether low-density lipoprotein (LDL) apheresis alters plasma ET-1 levels in diabetic hemodialysis patients with arteriosclerosis obliterans (ASO). Plasma ET-1 levels were measured in 30 healthy control subjects (Group A), 30 diabetes patients without ASO (Group B), 20 diabetes patients with ASO (Group C), 20 diabetes patients without ASO who were undergoing hemodialysis (Group D), and 6 diabetes patients with ASO who were undergoing hemodialysis (Group E). Hemodialysis patients were dialyzed three times weekly with a bicarbonate dialysate. Six diabetic hemodialysis patients with ASO underwent LDL apheresis once weekly for 10 weeks, and the change in plasma ET-1 levels due to LDL apheresis was measured. LDL apheresis resulted in a statistically significant decrease in levels of total cholesterol and LDL cholesterol. In addition, LDL apheresis improved clinical symptoms in all patients. Plasma ET-1 levels in Group E (15.0+/-1.9 pg/ml) were significantly higher than those in Groups A (1.0+/-0.6 pg/ml, P<.001), B (1.3+/-0.5 pg/ml, P<.001), C (5.6+/-1.0 pg/ml, P<.001), and D (10.4+/-1.6 pg/ml, P<.01). Plasma ET-1 levels decreased progressively and significantly after a single LDL apheresis began (9.4+/-1.0 pg/ml after 60 min, P<.001, and 6.0+/-1.0 pg/ml after 120 min, P<.001). These data suggest that ET-1 may be associated with arteriosclerosis and that LDL apheresis enhances peripheral microcirculation in part by reducing the production of ET-1 in diabetic hemodialysis patients with ASO.

• Authors: Tsukasa Nakamura, Chifuyu Ushiyama, Shiori Osada, Teruo Inoue, Noriaki Shimada, Hikaru Koide
• Journal: Journal of diabetes and its complications (J Diabetes Complications) 2003 Nov-Dec Vol. 17 Issue 6 Pg. 349-54 ISSN: 1056-8727 [Print] United States
• PMID: 14583180 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Endothelin-1
• Lipoproteins, LDL

Topics

• Adult
• Arteriosclerosis Obliterans (blood, complications, physiopathology)
• Blood Component Removal
• Diabetes Mellitus, Type 2 (blood, complications, physiopathology)
• Endothelin-1 (blood)
• Female
• Humans
• Lipoproteins, LDL (blood)
• Male
• Microcirculation (physiopathology)
• Middle Aged
• Reference Values
• Renal Dialysis
• Up-Regulation