Lipids, Apolipoproteins, Lipid Oxidation and Paraoxonase Enzyme Activity In Diabetic And Non-Diabetic End Stage Renal Disease Patients

araoxonase (PON) is a serum esterase, associated with HDL-C. It decreases the oxidation of LDL-C. Serum PON1 activity has been shown to diminish in several diseases. We investigated the serum PON1 activity and lipid profiles in diabetic and non-diabetic end stage renal disease (ESRD) patients and controls as well as serum PON1 activity pre and post dialysis.

Materials and Methods: For this study we recruited 92 patients with ESRD on hemodialysis, and 46 healthy controls. The patients were assigned into diabetic and non-diabetic groups (each, n=46 each). Serum lipid profiles including total cholesterol, triglycerides, HDL-C, apolipoprotein A-1, apolipoprotein B, Lipoprotein (a) serum PON activity, oxidized LDL-C and total antioxidant capacity were compared among groups. Furthermore, pre and post dialysis serum PON activity were also compared.

Results: Serum levels of total cholesterol, HDLC, LDL-C and apoA-I were lower in the ESRD patients, compared to controls. While serum PON activity was significantly lower in the ESRD than in controls, it did not differ significantly between diabetic and non-diabetic patients with ESRD. Serum PON activity was observed to rise significantly postdialysis, compared to predialysis, 69±48 vs. 72±50 IU/ml and 47±32 vs. 53±37 IU/ml in diabetic and non- diabetic patients respectively, the increase being significantly correlated with thequality of hemoidalysis.

Conclusion: To conclude, reduced serum paraoxonase activity in diabetes and non-diabetes ESRD may further predispose lipids to oxidation. Enhancement of the quality of hemodialysis can increase serum PON activity in hemodialysis patients.