Document Detail


Carotid atherosclerosis is associated with inflammation and endothelial cell adhesion molecules in chronic haemodialysis patients.
MedLine Citation:
PMID:  12480968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recently emerging evidence suggests that endothelial adhesion molecules may participate in atherogenesis. The aim of the present report was to investigate the probable association of circulating ICAM-1, VCAM-1 and E-selectin with atherosclerotic disease in chronic haemodialysis (HD) patients. METHODS: One hundred and twelve HD patients and 50 age- and sex-matched healthy normotensive controls participated in the study. Atherosclerotic disease in both groups was assessed by measuring intima-media thickness (IMT) and plaque score of the common carotid arteries using an ultrasound scanner. In addition, in a follow-up study, the survival of 81 patients after a mean period of 26 months was analysed in relation to ICAM-1 and VCAM-1 levels. RESULTS: IMT and plaque score were significantly higher in HD patients compared with control subjects (P < 0.001 and P < 0.0001, respectively). The above ultrasonographic indices were correlated with age both in controls (P = 0.0001 and P = 0.002, respectively) and HD patients (P = 0.0001 and P = 0.0001, respectively). A significant relationship was observed between IMT and systolic blood pressure (BP) both in controls and in HD patients (P = 0.002 and P = 0.01, respectively). In HD patients, plaque score was also correlated with systolic BP (P = 0.02). In HD patients, IMT and plaque score were correlated significantly with log CRP values (P = 0.01 and P = 0.01, respectively). Multivariate analysis showed that log CRP values were a strong independent contributor to plaque score (P = 0.01). IMT was significantly correlated with ICAM-1 and VCAM-1 concentrations (P = 0.0001 and P = 0.003, respectively). Multivariate analysis showed that ICAM-1 concentrations were a strong independent correlate of IMT (P = 0.001). E-selectin concentrations did not show any relation with IMT or plaque score. During the follow-up period, 13 of the 81 patients died. Survival analyses showed that patients with increased ICAM-1 had a shorter survival than patients with normal ICAM-1 values and that serum ICAM-1 levels were a strong predictor of death. CONCLUSIONS: In HD patients, carotid atherosclerosis is associated with inflammation and circulating levels of soluble adhesion molecules ICAM-1 and VCAM-1. The correlations between serum ICAM-1 and IMT and ICAM-1 and survival may indicate that this molecule could be a marker of a process that contributes to the high mortality of HD patients.
Authors:
Aikaterini Papagianni; Michalis Kalovoulos; Dimitrios Kirmizis; Andreas Vainas; Anna-Maria Belechri; Efstathios Alexopoulos; Dimitrios Memmos
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  18     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2002-12-13     Completed Date:  2003-07-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  113-9     Citation Subset:  IM    
Affiliation:
University Department of Nephrology, Hippokration General Hospital, Thessaloniki, Greece. aikpapag@otenet.gr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biological Markers / blood
Blood Pressure
Carotid Artery Diseases / complications,  pathology,  physiopathology*
Cell Adhesion Molecules / blood*
E-Selectin / blood
Female
Follow-Up Studies
Humans
Inflammation / etiology*
Intercellular Adhesion Molecule-1 / blood
Kidney Failure, Chronic / complications,  mortality,  therapy*
Male
Middle Aged
Multivariate Analysis
Reference Values
Regression Analysis
Renal Dialysis* / mortality
Risk Factors
Smoking
Survival Analysis
Time Factors
Vascular Cell Adhesion Molecule-1 / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cell Adhesion Molecules; 0/E-Selectin; 0/Vascular Cell Adhesion Molecule-1; 126547-89-5/Intercellular Adhesion Molecule-1

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