NDT Advance Access originally published online on January 28, 2009
Nephrology Dialysis Transplantation 2009 24(5):1587-1592; doi:10.1093/ndt/gfn760
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Alpha-tocopherol supplementation decreases electronegative low-density lipoprotein concentration [LDL(–)] in haemodialysis patients
1 Department of Clinical Nutrition, Federal Fluminense University (UFF), Niterói 2 Division.of Nephrology, Federal University of Rio de Janeiro (UFRJ), Nephrology Integrated Center, Rio de Janeiro 3 School of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo 4 Statistical Department, Federal Fluminense University (UFF), Niterói, Brazil
Correspondence and offprint requests to: Denise Mafra, R. Theodor Herzl, 56 apto 103, Botafogo, Rio de Janeiro, RJ, CEP 22260 030, Brazil. Tel: +55-21-22466022, +55-21-85683003; Fax: +55-21-26299847; E-mail: dmafra{at}terra.com.br
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Abstract |
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Background. Oxidative stress is a significant contributor to cardiovascular diseases (CVD) in haemodialysis (HD) patients, predisposing to the generation of oxidized low-density lipoprotein (oxLDL) or electronegatively charged LDL subfraction. Antioxidant therapy such as 
-tocopherol acts as a scavenger of lipid peroxyl radicals attenuating the oxidative stress, which decreases the formation of oxLDL. The present study was designed to investigate the influence of the -tocopherol supplementation on the concentration of electronegative low-density lipoprotein [LDL(–)], a minimally oxidized LDL, which we have previously described to be high in HD patients.
Methods. Blood samples were collected before and after 120 days of supplementation by -tocopherol (400 UI/day) in 19 stable HD patients (50 ± 7.8 years; 9 males). The concentrations of LDL(–) in blood plasma [using an anti-LDL– human monoclonal antibody (mAb)] and the anti-LDL(–) IgG auto-antibodies were determined by ELISA. Calculation of body mass index (BMI) and measurements of waist circumference (WC), triceps skin folds (TSF) and arm muscle area (AMA) were performed.
Results. The plasma -tocopherol levels increased from 7.9 µM (0.32–18.4) to 14.2 µM (1.22–23.8) after the supplementation (P = 0.02). The mean concentration of LDL(–) was reduced from 570.9 µg/mL (225.6–1241.0) to 169.1 µg/mL (63.6–621.1) (P < 0.001). The anti-LDL(–) IgG auto-antibodies did not change significantly after the supplementation. The -tocopherol supplementation also reduced the total cholesterol and LDL-C levels in these patients, from 176 ± 42.3 mg/dL to 120 ± 35.7 mg/dL (P < 0.05) and 115.5 ± 21.4 mg/dL to 98.5 ± 23.01 mg/dL (P < 0.001), respectively.
Conclusion. The oral administration of -tocopherol in HD patients resulted in a significant decrease in the LDL(–), total cholesterol and LDL-C levels. This effect may favour a reduction in cardiovascular risk in these patients, but a larger study is required to confirm an effect in this clinical setting.
Keywords: -tocopherol; cardiovascular disease; electronegative LDL; haemodialysis
Received for publication: 4. 9.08
Accepted in revised form: 18.12.08