Oxidative Stress Accelerated Atherosclerosis

Oxidative Stress Accelerated Atherosclerosis

Dursun B, Dursun E, Suleymanlar G, Ozben B, Capraz I, Apaydin A, Ozben
T
Carotid Artery Intima-media Thickness Correlates with Oxidative Stress
in Chronic Haemodialysis Patients with Accelerated Atherosclerosis.
Nephrol Dial Transplant 2008 Jan 3.

Background.
Accelerated atherosclerosis is the major cause of mortality in
patients on chronic haemodialysis (HD). Increased oxidative stress
might be the major factor leading to high cardiovascular mortality
rate in HD patients.
The aim of our study was to clarify effects of uraemia and dialysis on
oxidative stress parameters and explore the relation between oxidative
stress markers and carotid artery intima-media thickness (CIMT) as an
indicator of atherosclerosis.
Methods.
Twenty chronic HD patients, 20 predialytic uraemic patients and 20
healthy subjects were included in the study. Serum thiobarbituric acid
reactive substances (TBARS), protein carbonyl content (PCO) and
nitrite/nitrate levels were determined as oxidative stress markers.
Serum vitamin E, plasma sulfhydryl (P-SH), erythrocyte glutathione
(GSH), superoxide dismutase (SOD), catalase (CAT) and glutathione
peroxidase (GPx) activities were measured as antioxidants. CIMT was
assessed by carotid artery ultrasonography.
Results.
Both chronic HD and predialytic uraemic patients had enhanced
oxidative stress indicated by higher levels of nitrite/nitrate, TBARS
and PCO, and lower levels of P-SH, SOD, CAT and GPx compared to
controls. HD patients had significantly higher CIMT and nitrite/
nitrate while significantly lower P-SH,vitamin E, SOD, CAT and GPx
compared to predialytic uraemic patients. There was a significant
positive correlation between CIMT and TBARS (r = 0.38, P = 0.003) and
nitrite/nitrate levels (r = 0.41, P = 0.001), while there was a
significant negative correlation between CIMT and SOD (r = -0.35, P =
0.01), CAT (r = -0.65, P < 0.001) and P-SH levels (r = -0.50, P <
0.001). A linear regression analysis showed that TBARS were still
significantly and positively correlated with CIMT (P = 0.001), while
CAT and P-SH were significantly and negatively correlated with CIMT (P
= 0.002 and P = 0.048, respectively).
Conclusions.
HD exacerbates oxidative stress and disturbances in antioxidant
enzymes in uraemic patients. We propose that serum TBARS and nitrite/
nitrate can be used as positive determinants, while erythrocyte SOD,
CAT and P-SH may be used as negative determinants of atherosclerosis
assessed by CIMT in uraemic and HD patients.


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