Butyrylcholinesterase activity, cardiovascular risk factors, and mortality in middle-aged and elderly men and women in Jerusalem

BACKGROUND: The association of butyrylcholinesterase (BuChE) with Alzheimer disease and the association of this disease with cardiovascular risk factors raise interest in the association of BuChE activity with cardiovascular risk factors and mortality. METHODS: A baseline cross-sectional study was conducted between 1985 and 1987, encompassing residents > or =50 years of age living in a Jewish neighborhood in western Jerusalem. Interviews were followed by examinations and nonfasting blood sampling (available for 1807 participants). Follow-up data to April 1996 on mortality and causes of death were obtained through record linkage with the Israeli Population Registry. RESULTS: BuChE activity was inversely related to age and was positively associated with serum concentrations of albumin (r = 0.35; P <0.001), cholesterol (r = 0.31; P <0.001), and triglycerides (r = 0.30; P <0.001). Enzyme activity was associated with measures of overweight, obesity, and body fat distribution (e.g., body mass index, r = 0.20; P <0.001). In multivariate analysis, the associations of enzyme activity with serum cholesterol, triglycerides, and albumin persisted strongly. After adjustment by Cox proportional hazards regression for other predictors of mortality in this population, individuals in the lowest quintile of BuChE activity had significantly higher mortality than those in the highest quintile [hazard ratios (95% confidence intervals): all-cause mortality, 1.62 (1.15-2.30); cardiovascular deaths, 1.79 (1.05-3.05)]. The association was attenuated by introduction of serum albumin into the models. CONCLUSIONS: This is the first study to report on the association between BuChE and mortality. The relatively strong association of BuChE with serum lipid and albumin concentrations requires elucidation. Our results suggest that low BuChE activity may be a nonspecific risk factor for mortality in the elderly.     

Butyrylcholinesterase activity and risk factors for coronary artery disease

The aim of this study was to verify which risk factors for coronary artery disease (CAD) are independently correlated with butyrylcholinesterase (BChE) activity. We studied 88 White individuals (43 males) aged 47.3+/-15.7 years (mean+/-SD; range: 14.0-80.0 years) including 38 with hyperlipidemia, 30 with hypertension and 5 with diabetes mellitus (DM). Simple correlation analysis showed that BChE activity was positively correlated with age, sex, body mass index, hypertension and DM, as well as with triglycerides (TGs), total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B (Apo B). However, after a step-wise multiple regression analysis, the only risk factors for CAD that showed independent correlations with BChE activity were, in descending order of importance, Apo B, TGs and DM. Our findings seem to reinforce suggested associations of BChE activity with lipoprotein synthesis and with hypertension, as well as supporting previous data on the relation of BChE activity with disturbances found in diabetes mellitus.     

Butyrylcholinesterase activity and risk factors for coronary artery disease

The aim of this study was to verify which risk factors for coronary artery disease (CAD) are independently correlated with butyrylcholinesterase (BChE) activity. We studied 88 White individuals (43 males) aged 47.3 &#45 15.7 years (mean &#45 SD; range: 14.0 - 80.0 years) including 38 with hyperlipidemia, 30 with hypertension and 5 with diabetes mellitus (DM). Simple correlation analysis showed that BChE activity was positively correlated with age, sex, body mass index, hypertension and DM, as well as with triglycerides (TGs), total cholesterol, lowdensity lipoprotein cholesterol and apolipoprotein B (Apo B). However, after a step-wise multiple regression analysis, the only risk factors for CAD that showed independent correlations with BChE activity were, in descending order of importance, Apo B, TGs and DM. Our findings seem to reinforce suggested associations of BChE activity with lipoprotein synthesis and with hypertension, as well as supporting previous data on the relation of BChE activity with disturbances found in diabetes mellitus.     

Butyrylcholinesterase activity in young men and women: association with cardiovascular risk factors

ObjectiveWe investigated the relationship between butyrylcholinesterase (BuChE) and cardiovascular risk factors in young male and female.Design and methodsThe study comprised 1512 healthy subjects, 18–25 years of age. In fasting sera the concentrations of BuChE and cardiovascular risk factors were estimated.ResultsAnalysis of variance indicated significant increase in body mass index (BMI), total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL) (p < 0.05) and albumin (p < 0.001) with BuChE activity increment in males. In females glucose and albumin (p < 0.05) increased with BuChE activity. Negative but not significant correlation between BuChE and high-density lipoprotein cholesterol (HDL-C) was detected for both genders.ConclusionThe tendency towards overweight in young male could explain our results on BMI as an independent risk factor for higher BuChE in young male. Glucose as an independent risk factor for higher BuChE activity in females indicates that BuChE may be a predictor of diabetes.     

Butyrylcholinesterase activity and metabolic syndrome in obese patients.

Total butyrylcholinesterase activity (EC 3.1.1.8) was previously suggested as a marker for metabolic syndrome. The present study examined total butyrylcholinesterase activity and the relative and absolute activities of two butyrylcholinesterase electrophoretic bands (C(4/5) and C(OF) in 99 obese individuals (body mass index > or = 30 kg/m2) presenting the CHE2 C5- phenotype of the CHE2 gene. Anthropometric, hormonal and biochemical variables already associated with metabolic syndrome were also examined. The data from these obese individuals of the CHE2 C5- phenotype show that total butyrylcholinesterase activity and the absolute activities of the C(4/5) and C(OF) electrophoretic bands are associated with metabolic syndrome and with variables related to it. These butyrylcholinesterase activities do not behave as independent risk factors for metabolic syndrome, but can be considered as secondary markers for this syndrome in obese individuals with the CHE2 C5- phenotype.     

不同营养评估方法与维持性血液透析患者死亡关系的比较

目的 本研究的目的是研究不同的营养评估方法与维持性血液透析患者的预后的关系. 方法 对我院血液透析中心的83名患者进行营养评估,包括主观综合性营养评估（subjective global assessment,SGA）、营养不良-炎症评分（malnutrition inflammation score,MIS）和微型营养评定简表（mini nutrition assessment short form,MNA-SF）.同时收集基本资料、辅助检查结果.随访48月（40±13月）,采用Kaplan-Meier以及Cox回归分析比较不同营养评估方法与患者全因死亡风险的差别. 结果 Kaplan-Meier分析提示：SGA＜25分患者的死亡风险较SGA≥25分患者高（P＜0.05）,MIS＞10分组比MIS≤10分死亡风险高（P＞0.05）.以MNA-SF分组,MNA-SF≥11分死亡风险低于NA-SF＜11分（P＞0.05）.多因素Cox回归分析提示,SGA及MIS不同分组仍然与维持性血液透析患者不同的全因死亡风险有关（P＜0.05）. 结论 不同营养评估方法对于维持性血液透析患者长期生存的预测能力不同,SGA法以及MIS法所评价的营养状况与维持性血液透析患者长期的全因死亡风险有较好相关性.     

血液透析患者血清白蛋白水平与系统炎症反应的相关关系

目的研究血液透析患者血清白蛋白水平与系统炎症反应的关系.方法选择56例维持性血液透析患者,根据血清白蛋白(Albumin,Alb)水平分为两组:Alb<40g/L组和Alb≥40g/L组,比较两组白细胞介素6(interleukin-6,IL-6)、超敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)和纤维蛋白原水平,并进行相关性分析.结果 Alb<40g/L组IL-6、hs-CRP和纤维蛋白原水平均较Alb≥40g/L组高,差异具有非常显著性(P<0.01).多元回归分析在矫正了年龄的影响后,IL-6是血液透析患者血清白蛋白水平的独立影响因素.结论血液透析患者血清白蛋白水平与系统炎症反应密切相关,提示血液透析患者营养不良的发生与存在的系统炎症反应有关.     

Circulating fetuin-A predicts early mortality in chronic hemodialysis patients

ObjectivesThe purpose of this study was to assess whether low serum levels of fetuin-A are potential biochemical predictor of early and/or late survival in chronic hemodialysis (HD) patients.Design and methodsWe measured serum levels of fetuin-A in 67 patients on chronic HD, and correlated it to 3, 12, and 24 months mortality.ResultsCumulative death rate was 7%, 19%, and 37% deaths at 3, 12, and 24 months. Serum fetuin-A was significantly lower in 3 months and 12 months non-survivals (p < 0.001), but not in 24 months non-survivals. Kaplan–Meier analyses based on fetuin-A tertiles showed statistically significantly increased probability of death up to 12 months of follow-up for decreasing fetuin-A concentrations (p < 0.008).ConclusionsFetuin-A as a circulating inhibitor of vascular calcification was significant predictor of early mortality in chronic HD patients but did not appear as a fair marker for later survival.     

Disappearance of association in diabetic patients on hemodialysis between anemia and mortality risk: the Japan dialysis outcomes and practice pattern study

We previously demonstrated that anemia was not associated with mortality in hemodialysis patients with cardiovascular disease (CVD). Since diabetes mellitus (DM) accelerates CVD, the influence of DM on the relationship between anemia and mortality was examined using the data obtained from 1,385 DM patients and 2,583 non-DM hemodialysis patients recruited into the Dialysis Outcomes Practice Pattern Study in Japan (J-DOPPS). When all patients were stratified into four groups on their hematocrit levels, mortality rate was significantly and steadily lower in the subgroups with the higher levels of hematocrit by the Kaplan-Meier method (p = 0.0003 by log-rank test). When DM and non-DM patients were analyzed separately, a significant association of lower hematocrit levels with higher mortality disappeared in DM patients (p = 0.6280), in contrast with its retention in non-DM counterparts (p < 0.0001). Multivariable-adjusted Cox proportional hazards models demonstrated a significant association between hematocrit with all-cause mortality in non-DM patients after adjustment for age, gender, BMI, hemodialysis duration, SBP, DBP, albumin, total cholesterol, calcium, phosphorus, and intact PTH (p = 0.046), whereas this association disappeared in DM patients in the same model (p = 0.583). In conclusion, these results suggested that the association between anemia and higher mortality disappeared in DM hemodialysis patients, in contrast with non-DM counterparts.     

红细胞分布宽度升高是血液透析患者心血管死亡的独立危险因素

目的在心血管疾病(cardiovascular disease,CVD)患者中,红细胞分布宽度(red blood cell distribution width,RDW)与心血管死亡及全因死亡相关。但在血液透析患者中,RDW与CVD及预后的相关性尚无报道。因此,本研究旨在探讨RDW对血液透析患者心血管事件发生及死亡的影响。方法纳入广东省人民医院血液透析患者共286名,随访时间为2009年1月1日~2014年12月31日。记录一般资料、实验室检查等,终点是心血管事件、心血管死亡及全因死亡。结果平均随访时间57.2月,286名血液透析患者中96人(33.5%)死亡,57人(19.9%)发生心血管死亡,119人(42%)发生心血管事件。多因素生存分析,经校正后,RDW仍是全因死亡、心血管死亡及心血管事件的独立危险因素,危险比值分别为1.36(95%CI 1.17~1.58,P0.001)、1.38(95%CI 1.16~1.64,P0.001)和1.22(95%CI1.06~1.40,P=0.006)。结论 RDW升高是血液透析患者全因死亡及心血管死亡和心血管事件的独立危险因素。     

Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

BACKGROUND. Cardiovascular disease (CVD) is the major cause of mortality and morbidity of hemodialysis (HD) and peritoneal dialysis (CAPD) patients. We aimed to investigate the cardiovascular risk factors and their correlation with CVD in groups of HD and CAPD patients. METHODS. Thirty HD patients, 30 CAPD patients and 30 healthy controls were included in the study. Apolipoprotein A-l (apo A-l), apolipoprotein B (apo B), apolipoprotein(a) [Lp(a)] and high-sensitivity CRP (hs-CRP) were measured with a Beckman Coulter nephelometer, and homocysteine (Hcy) was determined with an Agilent HPLC analyzer. Lipid profile was determined with a Synchron LX 20 Pro analyzer. RESULTS. Hcy levels were 41.9+/-19.4, 41.8+/-38.5 and 9.3+/-3.5 micromol/L; Lp(a) levels were 325+/-315, 431+/-367 and 130+/-97 mg/L; hs-CRP levels were 3.78+/-3.21, 4.34+/-3.39 and 2.07+/-1.67 mg/L; apo A1/apo B ratios were 1.46+/-0.6, 1.36+/-0.5 and 1.80+/-0.59; total cholesterol levels were 3.56+/-0.7, 4.84+/-1.1 and 4.39+/-0.5 mmol/L; triglycerides were 1.44+/-0.5, 1.60+/-0.8 and 0.85+/-0.5 mmol/L in the HD, CAPD and control groups, respectively. CONCLUSION. HD and CAPD patients had higher Hcy, hs-CRP and Lp(a) levels and lower apo A/B ratios than controls. There was no significant difference between the HD and CAPD groups. Hypertension, age and hs-CRP showed a positive correlation with CVD.     

血清尿酸水平与维持性血液透析患者死亡率的相关性

目的 探讨血清尿酸（serum uric acid,SUA）水平对维持性血液透析（maintenance hemodialysis,MHD）患者全因死亡率和心脑血管疾病死亡率的影响。 方法 回顾性收集2015年1月1日至2016年12月31日在复旦大学附属中山医院行维持性血液透析的患者的临床资料,根据SUA水平的三分位间距将患者分为3组,比较3组患者临床资料和实验室检查结果的差异。采用Kaplan-Meier法绘制生存曲线,Log-rank检验比较3组患者生存率的差异。多元Cox回归方程法分析MHD患者SUA和全因死亡率、心脑血管疾病死亡率的关系。采用ROC曲线分析SUA对全因死亡和心脑血管疾病死亡的预测效果。 结果 共入选436例MHD患者,男性270例（61.9%）,中位年龄60（48,67）岁,中位随访时间59.7（38.4,60.9）个月。根据SUA水平的三分位间距将患者分为3组：低SUA组（SUA≤399 μmol/L,n=149）、中SUA组（SUA 400~460 μmol/L,n=144）、高SUA组（SUA≥461 μmol/L,n=143）。在随访期间共130例死亡,其中90例（69.2%）死于心脑血管疾病。Kaplan-Meier生存分析结果显示,低UA组患者总生存率和心脑血管疾病生存率低于中UA组和高UA组。采用Cox回归分析校正年龄、性别、合并症等因素,结果显示SUA水平每增加10 μmol/L,患者的全因死亡风险下降2.6%（HR=0.974,95%CI 0.952~0.996,P=0.022）,心脑血管疾病死亡风险下降3.7%（HR=0.963,95%CI 0.937~0.991,P=0.008）;低SUA组患者的全因死亡和心脑血管疾病的死亡风险显著高于高SUA组（分别HR=1.841,95%CI 1.138~2.979,P=0.013;HR=2.353,95%CI 1.288~4.300,P=0.005）。结论 低SUA水平是MHD患者全因死亡和心脑血管疾病死亡的独立危险因素。     

Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

Background. Cardiovascular disease (CVD) is the major cause of mortality and morbidity of hemodialysis (HD) and peritoneal dialysis (CAPD) patients. We aimed to investigate the cardiovascular risk factors and their correlation with CVD in groups of HD and CAPD patients. Methods. Thirty HD patients, 30 CAPD patients and 30 healthy controls were included in the study. Apolipoprotein A‐l (apo A‐l), apolipoprotein B (apo B), apolipoprotein(a) [Lp(a)] and high‐sensitivity CRP (hs‐CRP) were measured with a Beckman Coulter nephelometer, and homocysteine (Hcy) was determined with an Agilent HPLC analyzer. Lipid profile was determined with a Synchron ^®LX 20 Pro analyzer. Results. Hcy levels were 41.9±19.4, 41.8±38.5 and 9.3±3.5?µmol/L; Lp(a) levels were 325±315, 431±367 and 130±97?mg/L; hs‐CRP levels were 3.78±3.21, 4.34±3.39 and 2.07±1.67?mg/L; apo A1/apo B ratios were 1.46±0.6, 1.36±0.5 and 1.80±0.59; total cholesterol levels were 3.56±0.7, 4.84±1.1 and 4.39±0.5?mmol/L; triglycerides were 1.44±0.5, 1.60±0.8 and 0.85±0.5?mmol/L in the HD, CAPD and control groups, respectively. Conclusion. HD and CAPD patients had higher Hcy, hs‐CRP and Lp(a) levels and lower apo A/B ratios than controls. There was no significant difference between the HD and CAPD groups. Hypertension, age and hs‐CRP showed a positive correlation with CVD.