Elevated Lipoprotein(a) Levels are Associated with Arterial Stiffness Measured by Cardio-Ankle Vascular Index in Patients Undergoing Peritoneal Dialysis

Elevated Lipoprotein(a) Levels are Associated with Arterial Stiffness Measured by Cardio-Ankle Vascular Index in Patients Undergoing Peritoneal Dialysis

Po-Yu Huang^1,2,†, Bang-Gee Hsu^2,3,†, Huei-Jhen Lin³, Yu-Li Lin^2,3, Chih-Hsien Wang^2,3, Jen-Pi Tsai^1,2,*

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¹ Division of Nephrology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 62247 Chiayi, Taiwan

² School of Medicine, Tzu Chi University, 97004 Hualien, Taiwan

³ Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 97004 Hualien, Taiwan

^*Correspondence: tsaininimd1491@gmail.com (Jen-Pi Tsai)
^†These authors contributed equally.

Rev. Cardiovasc. Med. 2023, 24(11), 322; https://doi.org/10.31083/j.rcm2411322

Submitted: 21 July 2023 | Revised: 15 August 2023 | Accepted: 22 August 2023 | Published: 23 November 2023

(This article belongs to the Special Issue Lipoproteins and Lipids in Cardiovascular Disease)

This is an open access article under the CC BY 4.0 license.

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Abstract

Background: Arterial stiffness (AS) can be used to predict future cardiovascular diseases. High lipoprotein(a) (Lp(a)) levels were independently correlated with cardiovascular (CV) morbidity and death in patients with chronic renal insufficiency. The cardio-ankle vascular index (CAVI) is a useful biomarker of arteriosclerotic disorders and has a close relationship with a variety of CV events. This study aimed to investigate the correlation between serum Lp(a) levels and AS in patients on peritoneal dialysis (PD) using the CAVI. Methods: A total of 86 adult patients who were on regular PD for at least 3 months were recruited in this study. The CAVI values were determined using the waveform device (VaSera VS-1000). A CAVI value of $\geq$ 9.0 on either side was defined as high. Serum Lp(a) levels were measured by an enzyme-linked immunosorbent assay. Results: Among these participants, 35 of 86 (40.7%) belonged to the high CAVI group. In contrast to those with a normal CAVI, PD recipients in the high CAVI group had higher serum levels of total cholesterol (p = 0.003), triglycerides (p = 0.044), C-reactive protein (p $<$ 0.001), and Lp(a) (p $<$ 0.001), whereas their albumin levels were significantly lower (p = 0.026). Based on multivariable logistic regression analysis, serum Lp(a) (odds ratio [OR] 1.025, 95% confidence interval [CI] 1.010–1.040, p = 0.001), total cholesterol (OR 1.042, 95% CI 1.005–1.081, p = 0.027), and C-reactive protein (each increase 0.1 mg/dL, OR 1.217, 95% CI 1.008–1.469, p = 0.041) levels were found as the parameters that could independently predict AS in patients on PD. Further, using Spearman’s correlation analysis, both the left and right CAVIs revealed a significantly positive correlation with log-transformed Lp(a) levels (r = 0.588, p $<$ 0.001; r = 0.639, p $<$ 0.001, respectively). Conclusions: Serum Lp(a) levels were postulated to participate in the pathogenic processes of AS in adult patients undergoing PD.

Keywords

cardio-ankle vascular index

arterial stiffness

lipoprotein(a)

peritoneal dialysis

Funding

TCRD-112-021/Hualien Tzu Chi Hospital

TCMF-CP 110-02/Buddhist Tzu Chi Medical Foundation

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