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Titolo:
HYPERHOMOCYSTEINEMIA, HYPERFIBRINOGENEMIA, AND LIPOPROTEIN (A) EXCESSIN MAINTENANCE DIALYSIS PATIENTS - A MATCHED CASE-CONTROL STUDY
Autore:
BOSTOM AG; SHEMIN D; LAPANE KL; SUTHERLAND P; NADEAU MR; WILSON PWF; YOBURN D; BAUSSERMAN L; TOFLER G; JACQUES PF; SELHUB J; ROSENBERG IH;
Indirizzi:
TUFTS UNIV,NEW ENGLAND MED CTR,JEAN MAYER USDA HUMAN NUTR RES CTR AGING,711 WASHINGTON ST BOSTON MA 02111 RHODE ISL HOSP,DIV RENAL DIS PROVIDENCE RI 02902 MEM HOSP RHODE ISL,DEPT HLTH EDUC PAWTUCKET RI 00000 FRAMINGHAM HEART DIS EPIDEMIOL STUDY FRAMINGHAM MA 00000 MIRIAM HOSP,LIPID METAB LAB PROVIDENCE RI 00000 DEACONESS HOSP,INST PREVENT CARDIOVASC DIS BOSTON MA 00000
Titolo Testata:
Atherosclerosis
fascicolo: 1, volume: 125, anno: 1996,
pagine: 91 - 101
SICI:
0021-9150(1996)125:1<91:HHAL(E>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
STAGE RENAL-DISEASE; AMBULATORY PERITONEAL-DIALYSIS; ENDOTHELIUM-DEPENDENT DILATION; SERUM TOTAL HOMOCYSTEINE; CORONARY-ARTERY DISEASE; ISCHEMIC-HEART-DISEASE; CONTAINING AMINO-ACIDS; RISK FACTOR; CARDIOVASCULAR-DISEASE; PLASMA HOMOCYSTEINE;
Keywords:
FIBRINOGEN; LP(A); END-STAGE RENAL DISEASE; ARTERIOSCLEROSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
79
Recensione:
Indirizzi per estratti:
Citazione:
A.G. Bostom et al., "HYPERHOMOCYSTEINEMIA, HYPERFIBRINOGENEMIA, AND LIPOPROTEIN (A) EXCESSIN MAINTENANCE DIALYSIS PATIENTS - A MATCHED CASE-CONTROL STUDY", Atherosclerosis, 125(1), 1996, pp. 91-101

Abstract

Maintenance dialysis patients experience an exceedingly high incidence of arteriosclerotic cardiovascular disease (CVD) events that are poorly predicted by traditional CVD risk factor indices. We evaluated theprevalence of three non-traditional CVD risk factors, i.e. hyperhomocysteinemia, hyperfibrinogenemia, and lipoprotein (a) (Lp(a)) excess, and combined hyperhomocysteinemia, hyperfibrinogenemia, and Lp(a) excess, in maintenance dialysis patients. Fasting total plasma homocysteine(Hey), fibrinogen, Lp(a), glucose, and total and HDL cholesterol levels, and traditional CVD risk factor (i.e. glucose tolerance, smoking, hypertension, dyslipidemia) prevalences were assessed in 71 dialysis patients and 71 age, sex, and race matched Framingham Study controls free of clinical renal disease, with normal serum creatinine (less than or equal to 1.5 mg/dl). Mean plasma Hey (23.7 vs. 9.9 mu M P = 0.0001), fibrinogen (457 vs. 309 mg/dl, P = 0.0001), and Lp(a) (30 vs. 17 mg/dl, P = 0.0070) levels were substantially increased in the dialysis patients. Matched odds ratios (with 95% confidence intervals), dialysis patients/controls, for hyperhomocysteinemia, hyperfibrinogenemia, and Lp(a) excess, alone or combined, were markedly greater in the dialysispatients, with no evidence of confounding by the traditional CVD riskfactors: hyperhomocysteinemia, 105.0 (29.9-368.9); hyperfibrinogenemia, 16.6 (6.6-42.0); Lp(a) excess, 3.5 (1.5-8.4); all three combined 35.0 (5.7-199.8). Given in vitro evidence that Hcy, Lp(a), and fibrinogen interact to promote atherothrombosis, combined hyperhomocysteinemia,hyperfibrinogenemia, and Lp(a) excess may contribute to the high incidence of vascular disease sequelae experienced by dialysis patients, which is inadequately explained by traditional CVD risk factors. Controlled, prospective studies of well-characterized maintenance dialysis cohorts are urgently required to substantiate this hypothesis.

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Documento generato il 03/04/20 alle ore 20:25:46