Metabolic syndrome in children with chronic kidney disease: PON1 and treatment modality

Arch Med Res. 2013 Nov;44(8):645-9. doi: 10.1016/j.arcmed.2013.10.014. Epub 2013 Nov 8.

Abstract

Background and aims: We undertook this study to evaluate the relationship between PON1, SOD and metabolic syndrome (MetS) in pediatric patients undergoing peritoneal dialysis, hemodialysis and patients in early stages of CKD.

Methods: We carried out an analytical cross-sectional study of 134 children 6-17 years old. We registered anthropometric variables, vital signs, basic biochemical parameters, intact PTH (iPTH), high sensitivity CRP (hs-CRP), paraoxonase-1; SOD; PON1/HDL-cholesterol and homocysteine. For statistical analyses we used t test, Mann Whitney U test, χ(2), Fisher exact test, linear or logistic regression models, using SPSS v.16.0. p values <0.05 were considered as significant.

Results: There were 66 (49.3%) females; 39 (29.1%) had CKD stages 2-4 (predialysis), 42 (31.3%) on hemodialysis (HD) and 53 (39.6%) on automated peritoneal dialysis (PD). Time from diagnosis was 26 months. Significant differences were observed in mean, systolic and diastolic blood pressure, C-peptide, triglycerides, and HDL-cholesterol as well as PON1/HDL-cholesterol ratio and SOD.

Conclusions: This study demonstrates that PON1 and SOD may be predictors for the presence of MetS in pediatric patients under treatment with peritoneal dialysis. The positive correlation observed in PON1/HDL-cholesterol ratio may reflect the protector effect of HDL-cholesterol in patients with CKD according with the modality of treatment.

Keywords: CKD treatment modality; Metabolic syndrome in children; PON1/HDL-cholesterol; Paraoxonase-1; SOD.

MeSH terms

  • Adolescent
  • Aryldialkylphosphatase / blood*
  • Child
  • Child, Preschool
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Early Diagnosis
  • Female
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / metabolism
  • Kidney Failure, Chronic / therapy*
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / metabolism*
  • Metabolic Syndrome / therapy*
  • Peritoneal Dialysis
  • Renal Dialysis
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / metabolism
  • Renal Insufficiency, Chronic / therapy*
  • Superoxide Dismutase / blood
  • Treatment Outcome

Substances

  • Cholesterol, HDL
  • Superoxide Dismutase
  • Aryldialkylphosphatase
  • PON1 protein, human