ATHEROGENIC LIPID PROFILE AND LIPOPROTEIN(A) IN RELATION TO SERUM-ALBUMIN IN HEMODIALYSIS-PATIENTS

Malnutrition in haemodialysis patients is associated with an increased cardiovascular mortality. Lipoprotein(a) (Lp(a)) is an independent ri sk factor for atherosclerotic cardiovascular disease. To evaluate the relationship between atherogenic lipid profile and serum albumin in ha emodialysis patients we measured fasting serum Lp(a), total cholestero l (TC), high-density lipoprotein-cholesterol (HDL-C), triglyceride (TG ), apoprotein A-I (ApoA-I), apoprotein B (ApoB) and albumin in 101 hae modialysis patients and in 46 healthy subjects as a control. The haemo dialysis patients were divided into two groups on the basis of the lev el of serum albumin: group I, serum albumin < 4.0 g/dl; group II, seru m albumin greater than or equal to 4.0 g/dl. Haemodialysis patients as whole (n = 101, 17.1 mg/dl (10.3 - 30.9)) had higher serum Lp(a) than normal subjects (n = 46, 10.5 mg/dl (3.3 - 24)) (P < 0.05). Lp (a) in group I (n = 38, 27.1 mg/dl (14.6 - 35.0)) was significantly higher t han in group II (n = 63, 14.5 mg/dl (7.7 - 21.7), P < 0.005) and norma l subjects (P < 0.0005). However, serum Lp(a) level of group II was no t different from those of normal subjects. There was a significant inv erse correlation between serum Lp(a) and albumin concentration (r(s) = -0.26, P < 0.01). TC, TG, HDL-C, ApoA-I, ApoB, TC/HDL-C, and ApoA-I/A poB ratios were not different between group I and group II. No correla tion was found between albumin and TC, TG, HDL-C, TC/HDL-C, and ApoA-I /ApoB ratios. These results suggest that Lp(a) could be responsible fo r an increased cardiovascular mortality in haemodialysis patients with malnutrition.