Received October 12, 2005
Accepted on January 1, 2006

ORIGINAL ARTICLES

Statin Treatment and Diabetes Affect Myeloperoxidase Activity in Maintenance Hemodialysis Patients

Peter Stenvinkel ^*1, Ernesto Rodríguez-Ayala , Ziad A. Massy , Abdul Rashid Qureshi , Peter Barany ^*, Bengt Fellström ^||, Olof Heimburger ^*, Bengt Lindholm , and Anders Alvestrand ^*

Divisions of *Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden; Unidad de Investigación Médica en Enfermedades Nefrológicas Centro Médico Nacional Siglo XXI Instituto Mexicano del Seguro Social México D.F., Mexico City, Mexico; INSERM ERI-12, University of Picardie and Amiens University Hospital, Amiens, France; and ||Department of Medical Sciences, Renal Unit, University Hospital, Uppsala, Sweden

¹ To whom correspondence should be addressed. E-mail: peter.stenvinkel{at}ki.se.

	Abstract

Myeloperoxidase (MPO), which is secreted during activation of neutrophils, may serve as one mechanistic link among persistent inflammation, oxidative stress, and cardiovascular disease. This study related MPO activity to inflammatory and oxidative stress biomarkers, comorbidity, and ongoing medication in prevalent hemodialysis (HD) patients. In a cross-sectional evaluation of 115 prevalent (vintage 25 mo) HD patients (62 men; 63 ± 1 yr), data on comorbidity (Davies score), diabetes, medication (statins and antihypertensive drugs), nutritional status (subjective global assessment), blood lipids (cholesterol, HDL cholesterol, and triglycerides), inflammatory biomarkers (serum albumin, C-reactive protein, TNF-, and IL-6), oxidative stress biomarkers (pentosidine, 8-hydroxydeoxyguanosine, and MPO activity) were recorded. Patients with MPO activity greater than the median had significantly (P < 0.05) lower serum albumin levels (33.2 ± 0.7 versus 35.0 ± 0.5 g/L), higher 8-hydroxydeoxyguanosine levels (1.26 ± 0.08 versus 1.05 ± 0.06 ng/ml), and a lower prevalence of statin treatment (18 versus 36%). Therefore, the median MPO activity was significantly (P < 0.05) lower (17.7 versus 26.6 OD630/min per mg protein) in the subgroup of 31 HD patients with ongoing statin treatment. In a multiple regression model, correction for the impact of age, gender, vintage, serum cholesterol, serum albumin, comorbidity, diabetes, and statin use, only diabetes (P < 0.01) and statin use (P < 0.01) were significantly associated to MPO activity. Fourteen patients who had diabetes and were receiving statin treatment had markedly (P = 0.001) lower median (19.9 versus 41.2 OD630/min per mg protein) MPO activity compared with 18 who had diabetes and were not taking statins. This cross-sectional study suggests that both diabetes and statin treatment affect MPO activity in prevalent HD patients.