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Article: Effect of low molecular weight heparin on bone metabolism and hyperlipidemia in patients on maintenance hemodialysis

TitleEffect of low molecular weight heparin on bone metabolism and hyperlipidemia in patients on maintenance hemodialysis
Authors
KeywordsHemodialysis
Hyperlipidemia
Low molecular weight heparin
Osteoporosis
Unfractionated heparin
Issue Date2001
PublisherWichtig Editore srl. The Journal's web site is located at http://www.artificial-organs.com
Citation
International Journal Of Artificial Organs, 2001, v. 24 n. 7, p. 447-455 How to Cite?
AbstractThe effect of low molecular weight heparin (LMWH) on serum lipid profile in hemodialysis remains controversial and its effect on bone metabolism has not been studied. A crossover study was conducted in 40 patients on stable hemodialysis using unfractionated heparin (UFH) for more than 24 months. These patients were then treated with a LMWH (nadroparin-Ca) for 8 months during hemodialysis and subsequently switched back to UFH for 12 months. Serum lipid profile, biochemical markers for bone metabolism, and bone densitometry (BMD) were monitored at four-month intervals while all medications remained unchanged. Cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), lipoprotein(a) (Lp(a)), apolipoprotein B (Apo B) were raised in 35%, 29%, 12%, 24% and 24% of patients respectively. High-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A1 (Apo A-1) were reduced in 47% and 9% of patients. Bone-specific alkaline phosphatase (BALP) and intact osteocalcin (OSC), both reflecting osteoblastic activity, were raised in 65% and 94% of patients. Tartrate-resistant acid phosphatase (TRACP) reflecting osteoclastic activity and parathyroid hormone (PTH) were elevated in 35% and 88% of patients. Following LMWH treatment, TC, Tg, Lp(a) and Apo B were reduced by 7%, 30%, 21% and 10% respectively (p<0.05 or <0.01) while Apo A-1 were raised by 7% (p<0.01). Simultaneously, TRACP was reduced by 13% (p<0.05). These biochemical changes were detected soon after 4 months of LMWH administration. Although BMD values in our patients were lower than those of age-matched normal subjects, significant changes were not observed with LMWH treatment. After switching back to UFH for hemodialysis, these biochemical indices reverted to previous values during UFH treatment with a significant higher level in TC and Apo B while serum Apo A-1 remained elevated. Our study suggests LMWH may partially alleviate hyperlipidemia and, perhaps, osteoporosis associated with UFH administration in patients on maintenance hemodialysis.
Persistent Identifierhttp://hdl.handle.net/10722/76562
ISSN
2015 Impact Factor: 1.005
2015 SCImago Journal Rankings: 0.585
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLai, KNen_HK
dc.contributor.authorHo, Ken_HK
dc.contributor.authorCheung, RCKen_HK
dc.contributor.authorLit, LCWen_HK
dc.contributor.authorLee, SKMen_HK
dc.contributor.authorFung, KSen_HK
dc.contributor.authorTong, MKLen_HK
dc.contributor.authorLam, CWKen_HK
dc.date.accessioned2010-09-06T07:22:33Z-
dc.date.available2010-09-06T07:22:33Z-
dc.date.issued2001en_HK
dc.identifier.citationInternational Journal Of Artificial Organs, 2001, v. 24 n. 7, p. 447-455en_HK
dc.identifier.issn0391-3988en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76562-
dc.description.abstractThe effect of low molecular weight heparin (LMWH) on serum lipid profile in hemodialysis remains controversial and its effect on bone metabolism has not been studied. A crossover study was conducted in 40 patients on stable hemodialysis using unfractionated heparin (UFH) for more than 24 months. These patients were then treated with a LMWH (nadroparin-Ca) for 8 months during hemodialysis and subsequently switched back to UFH for 12 months. Serum lipid profile, biochemical markers for bone metabolism, and bone densitometry (BMD) were monitored at four-month intervals while all medications remained unchanged. Cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), lipoprotein(a) (Lp(a)), apolipoprotein B (Apo B) were raised in 35%, 29%, 12%, 24% and 24% of patients respectively. High-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A1 (Apo A-1) were reduced in 47% and 9% of patients. Bone-specific alkaline phosphatase (BALP) and intact osteocalcin (OSC), both reflecting osteoblastic activity, were raised in 65% and 94% of patients. Tartrate-resistant acid phosphatase (TRACP) reflecting osteoclastic activity and parathyroid hormone (PTH) were elevated in 35% and 88% of patients. Following LMWH treatment, TC, Tg, Lp(a) and Apo B were reduced by 7%, 30%, 21% and 10% respectively (p<0.05 or <0.01) while Apo A-1 were raised by 7% (p<0.01). Simultaneously, TRACP was reduced by 13% (p<0.05). These biochemical changes were detected soon after 4 months of LMWH administration. Although BMD values in our patients were lower than those of age-matched normal subjects, significant changes were not observed with LMWH treatment. After switching back to UFH for hemodialysis, these biochemical indices reverted to previous values during UFH treatment with a significant higher level in TC and Apo B while serum Apo A-1 remained elevated. Our study suggests LMWH may partially alleviate hyperlipidemia and, perhaps, osteoporosis associated with UFH administration in patients on maintenance hemodialysis.en_HK
dc.languageengen_HK
dc.publisherWichtig Editore srl. The Journal's web site is located at http://www.artificial-organs.comen_HK
dc.relation.ispartofInternational Journal of Artificial Organsen_HK
dc.subjectHemodialysisen_HK
dc.subjectHyperlipidemiaen_HK
dc.subjectLow molecular weight heparinen_HK
dc.subjectOsteoporosisen_HK
dc.subjectUnfractionated heparinen_HK
dc.titleEffect of low molecular weight heparin on bone metabolism and hyperlipidemia in patients on maintenance hemodialysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0391-3988&volume=24&spage=447&epage=455&date=2001&atitle=Effect+of+low+molecular+weight+heparin+on+bone+metabolism+and+hyperlipidemia+in+patients+on+maintenance+hemodialysisen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid11510916-
dc.identifier.scopuseid_2-s2.0-0034788031en_HK
dc.identifier.hkuros69575en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034788031&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume24en_HK
dc.identifier.issue7en_HK
dc.identifier.spage447en_HK
dc.identifier.epage455en_HK
dc.identifier.isiWOS:000170248900005-
dc.publisher.placeItalyen_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridHo, K=15850509100en_HK
dc.identifier.scopusauthoridCheung, RCK=36832198300en_HK
dc.identifier.scopusauthoridLit, LCW=6602660237en_HK
dc.identifier.scopusauthoridLee, SKM=12788758400en_HK
dc.identifier.scopusauthoridFung, KS=8948874600en_HK
dc.identifier.scopusauthoridTong, MKL=7202033848en_HK
dc.identifier.scopusauthoridLam, CWK=8531362100en_HK

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