Korean J Med.  2003 Apr;64(4):442-451.

Correlations among C-reactive protein, hemostatic factors, apolipoproteins, and cardiac troponin T in patients undergoing continuous ambulatory peritoneal dialysis

Affiliations
  • 1Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea. sbkim@amc.seoul.kr

Abstract

BACKGROUND: There are several risk factors in the development of arteriosclerosis, including lipid parameters, inflammatory markers, and hemostatic factors. Efforts should be undertaken to identify the relationship among risk factors and underlying mechanisms of arteriosclerosis to improve long-term survival in dialysis patients. This study was performed to evaluate correlations among these risk factors and cardiac troponin T (cTnT) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
METHODS
Seventy-seven CAPD pateints (M: 50, F: 27; mean age 52.8+/-12.4 years) were enrolled in this study. We measured blood level of total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), apolipoprotein A-1 (apoA-1), apolipoprotein B (apoB), C-reactive protein (CRP), fibrinogen, d-dimer, von Willebrand factor (vWF), and cTnT monthly for three times. Thallium SPECT was performed in 32 of 77 patients.
RESULTS
Significant positive correlation was found between CRP and fibrinogen (r=0.71, p<0.001). CRP was also positively correlated with vWF (r=0.29, p=0.01). Significant inverse correlation was observed between prealbumin and CRP (r=-0.33, p=0.004). HDL-C and apoA-1 were also inversely correlated with CRP (r=-0.26, p=0.04; r=-0,27, p=0.02) and apoB was positively correlated with CRP (r=0.24, p=0.02). Multivariate analysis revealed that fibrinogen, prealbumin, HDL-C, and apoA-1 correlated independently with CRP. In patients with diabetes (n=35), cTnT levels were sigificantly higher than those in patients without diabetes (p<0.001), whereas albumin and prealbumin levels were significantly lower in patients with diabetes than those in patients without diabetes (p<0.001, p=0.002). Serum apoB, triglyceride, and total cholesterol were higher among patients with positive results in thallium SPECT than those with negative results.
CONCLUSION
It seems that inflammation is associated with an enhanced cardiovascular risk profile such as hemostatic factors and apolipoproteins. cTnT may be a useful predictive marker for mortality in dialysis patients.

Keyword

Arteriosclerosis; C-reactive protein; Hemostatic factor; Lipid; Troponin T

MeSH Terms

Apolipoprotein A-I
Apolipoproteins B
Apolipoproteins*
Arteriosclerosis
C-Reactive Protein*
Cholesterol
Dialysis
Fibrinogen
Humans
Inflammation
Mortality
Multivariate Analysis
Peritoneal Dialysis, Continuous Ambulatory*
Prealbumin
Risk Factors
Thallium
Tomography, Emission-Computed, Single-Photon
Triglycerides
Troponin T*
Troponin*
von Willebrand Factor
Apolipoprotein A-I
Apolipoproteins
Apolipoproteins B
C-Reactive Protein
Cholesterol
Fibrinogen
Prealbumin
Thallium
Triglycerides
Troponin
Troponin T
von Willebrand Factor
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