Skip to main content
Association of Serum Paraoxonase/Arylesterase Activity With All-Cause Mortality in Maintenance Hemodialysis Patients.
- Author(s): Suematsu, Yasunori;
- Goto, Masaki;
- Park, Christina;
- Nunes, Ane CF;
- Jing, WangHui;
- Streja, Elani;
- Rhee, Connie M;
- Cruz, Siobanth;
- Kashyap, Moti L;
- Vaziri, Nosratola D;
- Narayanaswami, Vasanthy;
- Kalantar-Zadeh, Kamyar;
- Moradi, Hamid
- et al.
Published Web Locationhttps://doi.org/10.1210/jc.2019-00334
ContextIn end-stage renal disease (ESRD), serum high-density lipoprotein cholesterol (HDL-C) level is not an accurate predictor of mortality, partly because it does not necessarily correlate with indices of HDL function. Paraoxonase (PON) is a major enzyme constituent of HDL and a key component of HDL antioxidant activity. Apolipoprotein A-I (Apo A-1) is the core HDL structural protein that plays a major role in various aspects of HDL function.
ObjectiveWe sought to examine PON activity and Apo A-I levels in patients with ESRD vs healthy controls.
Design and settingPON/arylesterase activity was measured in 499 patients with maintenance hemodialysis (MHD) and 24 healthy controls with similar distributions of age, sex, and race/ethnicity. Serum acrolein-modified Apo A-I was measured in 30 patients with MHD and 10 healthy controls.
Main outcome measuresMultilevel Cox models were used to assess associations among PON activity, Apo A-I, and HDL-C levels with 12-month all-cause mortality.
ResultsPON activity was significantly lower in patients with MHD vs controls. Furthermore, acrolein-modified Apo A-I levels were higher in patients with MHD vs controls. In fully adjusted models, high PON activity was associated with lower 12-month mortality, whereas no difference of mortality risk was observed across HDL-C levels. The combination of high PON and low Apo A-I compared with low PON and low Apo A-I was associated with lower mortality risk.
ConclusionsIn patients with MHD, PON activity had a stronger association with 12-month mortality than HDL-C. Future studies are needed to examine the role of these markers as potential diagnostic and therapeutic tools in ESRD.
For improved accessibility of PDF content, download the file to your device.