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Clinical Trial
. 2013 Oct 26:14:234.
doi: 10.1186/1471-2369-14-234.

Relationship between Icodextrin use and decreased level of small low-density lipoprotein cholesterol fractioned by high-performance gel permeation chromatography

Eiichiro Kanda  1 , Masumi Ai, Asami Iwamoto, Mitsuyo Okazaki, Yoshitaka Maeda, Sei Sasaki, Masayuki Yoshida
Affiliations
Clinical Trial

Relationship between Icodextrin use and decreased level of small low-density lipoprotein cholesterol fractioned by high-performance gel permeation chromatography

Eiichiro Kanda et al. BMC Nephrol. .

Abstract

Background: Because of the absorption of glucose in peritoneal dialysis (PD) solution, PD patients show an atherogenic lipid profile, which is predictive of poor survival in PD patients. Lipoprotein subclasses consist of a continuous spectrum of particles of different sizes and densities (fraction). In this study, we investigated the lipoprotein fractions in PD patients with controlled serum low-density lipoprotein (LDL) cholesterol level, and evaluated the effects of icodextrin on lipid metabolism.

Methods: Forty-nine PD patients were enrolled in this cross-sectional study in Japan. The proportions of cholesterol levels to total cholesterol level (cholesterol proportion) in 20 lipoprotein fractions were measured using an improved method of high-performance gel permeation chromatography (HPGPC).

Results: Twenty-six patients used icodextrin. Although no significant differences in cholesterol levels in LDL and high-density lipoprotein (HDL) were observed between the patients using icodextrin (icodextrin group) and control groups, HPGPC showed that the icodextrin group had significantly lower cholesterol proportions in the small LDL (t-test, p=0.053) and very small LDL (p=0.019), and significantly higher cholesterol proportions in the very large HDL and large HDL than the control group (p=0.037; p=0.066, respectively). Multivariate analysis adjusted for patient characteristics and statin use showed that icodextrin use was negatively associated with the cholesterol proportions in the small LDL (p=0.037) and very small LDL (p=0.026), and positively with those in the very large HDL (p=0.040), large HDL (p=0.047), and medium HDL (p=0.009).

Conclusions: HPGPC showed the relationship between icodextrin use and the cholesterol proportions in lipoprotein fractions in PD patients. These results suggest that icodextrin may improve atherogenic lipid profiles in a manner different from statin.

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Figures

Figure 1
Figure 1
Representative chromatographic pattern obtained by high-performance gel permeation chromatography. The chromatography system could detect the cholesterol (red line) and triglyceride (blue line) levels in lipoprotein fractions from a diabetic male patient using icodextrin with a total cholesterol level of 175 mg/dl and a total triglyceride level of 53 mg/dl. In this study, the cholesterol levels in lipoprotein fractions were analyzed. Arrow 1 indicates the peaks for VLDL and LDL; arrow 2, HDL; arrow 3, endogenous free glycerol. Abbreviations: VLDL, very-low-density lipoprotein; LDL, low-density lipoprotein; HDL, high-density lipoproteins.
Figure 2
Figure 2
Cholesterol proportions in each lipoprotein fractions in icodextrin group compared with those in control group. The average cholesterol proportion in each lipoprotein fraction is indicated in the graph. The values are compared between the groups by the t-test. *, p<0.05. Abbreviations: proportion, average of the proportion of cholesterol level in each lipoprotein fraction to total cholesterol level; control, control group; icodextrin, icodextrin group; F1-20, Fraction 1-20.
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