Hemodiyaliz hastalarında C vitamini infüzyonunun lipit profili, apolipoprotein B içeren lipoproteinlerin oksidasyonu ve serum paraoksonaz-arilesteraz enzim aktiviteleri üzerine etkisi
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Date
2007
Authors
Erdinç, Selda
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Hemodiyaliz hastalarında kardiyovasküler sistem hastalıkları en sık görülen komplikasyonlardır. Hemodiyaliz hastalarında eksikliği görülen C vitamininin yerine koyma tedavisi dışında anemi gibi çeşitli nedenlerle de kullanımı önerilmektedir. Önemli antioksidan moleküllerden biri olan C vitamini bazı koşullarda oksidasyonu kolaylaştırıcı etki de gösterebilmektedir. Ayrıca C vitamininin lipid profili üzerine etkili olduğunu gösteren çalışmalar da bulunmaktadır. Bu çalışmada C vitamini uygulamasının ateroskleroz gelişimi ile yakından ilişkili olan lipid profili ve oksidan-antioksidan sistem üzerine etkilerinin incelenmesi amaçlanmıştır. Bu amaçla Uludağ Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı Nefroloji Bilim Dalı Hemodiyaliz Ünitesi’nde tedavi alan 29 hasta çalışmaya alınmıştır. 4’er ay süre ile her diyaliz seansı sonrasında sırasıyla 100 ve 500 mg intravenöz C vitamini verilmiştir. Hastalarda 0. , 4. ve 8. ay sonunda lipid profili, serum paraoksonaz1/arilesteraz aktivitesi ve apolipoprotein B-içeren lipoproteinlerin oksidasyonu ve oksidasyona duyarlılıkları incelenmiştir. 4. ve 8. ay sonunda trigliserid düzeyi azalmış ve paraoksonaz aktivitesi giderek artmıştır. 8. ay sonunda total-kolesterol, HDL-kolesterol, LDL- kolesterol ve apolipoprotein B düzeyi ve apolipoprotein B-içeren lipoproteinlerin oksidasyona direncinde artış gözlenmiştir. Bu değişikliklerin C vitamini konsantrasyonları ile korelasyonu saptanmamıştır. Sonuçta 500 mg intravenöz C vitamini uygulamasının serum paraoksonaz1 aktivitesi ve apolipoprotein B-içeren lipoproteinlerin oksidasyona direncine olumlu etki göstererek kardiyovasküler sistem hastalıklarından korunmada rol oynayabileceği görüşüne varılmıştır.
Cardiovascular system disease are the most prevalent complications observed in patients treated with hemodialysis. Vitamin C, which is reduced in hemodialysis patients, is suggested to be used in the treatment of anemia, besides its resubstitution treatment. Although it is one the most important antioxidant molecules, vitamin C can also exert pro-oxidant activity. Vitamin C has also been reported to modify the lipid profile. The aim of the present study was to investigate the effects of vitamin C on the lipid profile and oxidant-antioxidant system that plays important roles in atherogenesis. For this purpose, 29 hemodialysis patients, that had been treated in the Hemodialysis Unit of Internal Medicine Department in Uludag University Medical Faculty, were included in this study. The patients were treated with 100 and 500 mg intravenous vitamin C for four months of periods, respectively. At the end of 4th and 8th months, lipid profile, serum paraoxonase activity and oxidation and oxidizability of apolipoprotein Bcontaining lipoproteins were investigated. Triglyceride levels and paraoxonase activity were significantly increased at the end of both 4 and 8 months. Total–cholesterol, HDL-cholesterol, LDL-cholesterol and apolipoprtein B levels were increased and oxidizability of apolipoprtein Bcontaining lipoproteins were reduced at the end of 8 mounths. There were not any significant correlations between vitamin C and any of the parameters. We conclude that 500 mg iv infusion of vitamin C may protect hemodialysis patients from development of cardiovascular system disease by increasing serum paraoxonase activity and reducing the oxidizability of apolipoprotein B-containing lipoproteins.
Cardiovascular system disease are the most prevalent complications observed in patients treated with hemodialysis. Vitamin C, which is reduced in hemodialysis patients, is suggested to be used in the treatment of anemia, besides its resubstitution treatment. Although it is one the most important antioxidant molecules, vitamin C can also exert pro-oxidant activity. Vitamin C has also been reported to modify the lipid profile. The aim of the present study was to investigate the effects of vitamin C on the lipid profile and oxidant-antioxidant system that plays important roles in atherogenesis. For this purpose, 29 hemodialysis patients, that had been treated in the Hemodialysis Unit of Internal Medicine Department in Uludag University Medical Faculty, were included in this study. The patients were treated with 100 and 500 mg intravenous vitamin C for four months of periods, respectively. At the end of 4th and 8th months, lipid profile, serum paraoxonase activity and oxidation and oxidizability of apolipoprotein Bcontaining lipoproteins were investigated. Triglyceride levels and paraoxonase activity were significantly increased at the end of both 4 and 8 months. Total–cholesterol, HDL-cholesterol, LDL-cholesterol and apolipoprtein B levels were increased and oxidizability of apolipoprtein Bcontaining lipoproteins were reduced at the end of 8 mounths. There were not any significant correlations between vitamin C and any of the parameters. We conclude that 500 mg iv infusion of vitamin C may protect hemodialysis patients from development of cardiovascular system disease by increasing serum paraoxonase activity and reducing the oxidizability of apolipoprotein B-containing lipoproteins.
Description
Keywords
Hemodiyaliz, Kardiyovaskuler sistem hastalığı, C vitamini, Paraoksonaz, Lipoprotein oksidasyonu, Hemodialysis, Cardiovascular system disease, Vitamin C, Paraoxonase, Lipoprotein oxidation
Citation
Erdinç, S. (2007). Hemodiyaliz hastalarında C vitamini infüzyonunun lipit profili, apolipoprotein B içeren lipoproteinlerin oksidasyonu ve serum paraoksonaz-arilesteraz enzim aktiviteleri üzerine etkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.