Relation of Serum ADMA, Apelin‐13 and LOX‐1 Levels with Inflammatory and Echocardiographic Parameters in Hemodialysis Patients

摘要

Abstract Cardiovascular diseases are the leading causes of mortality in patients with chronic kidney disease. Nitric oxide has a critical role in both endothelial dysfunction and the atherosclerosis process. We aimed to investigate the relationships between serum asymmetric dimethyl arginine (ADMA), LOX‐1, and Apelin‐13 levels, which are known to act over nitric oxide with endothelial dysfunction and cardiac morphology as well as with each other in hemodialysis patients. The study comprised a total of 120 patients (53?females and 67?males) receiving hemodialysis three times a week for at least 6?months and an age‐gender matched control group (55 females and 58 males). Serum ADMA, LOX‐1, and Apelin‐13 levels were measured using the ELISA technique. Echocardiography, 24‐h blood pressure monitoring by the Holter and carotid artery intima‐media thickness (CIMT) measurement was performed on all of the included subjects. The associations between serum ADMA, LOX‐1, and Apelin‐13 levels with CIMT, echocardiographic parameters [left ventricular mass (LVM) and left ventricular mass index (LVMI)], and inflammatory markers [high sensitive C‐reactive protein (hsCRP) and neutrophil lymphocyte ratio (NLR)] were evaluated by correlation analysis. Serum ADMA, Apelin‐13, and LOX‐1 levels were significantly higher in the hemodialysis group than the controls ( P? ?0.001, P? ?0.001, and P? ?0.001, respectively). CIMT, hsCRP, and NLR levels were also significantly higher in the hemodialysis group ( P? ?0.05, P? ?0.001, P? ?0.001, respectively). Significant correlations were observed among the serum ADMA, Apelin‐13, and LOX‐1 levels. Moreover, notably positive correlations were found between these three biochemical markers and LVM, LVMI, hsCRP, and CIMT. Serum ADMA, Apelin‐13, and LOX‐1 levels can be indicators not only for the inflammatory process but also for the pathogenesis of cardiovascular diseases in hemodialysis patients.