Paraoxonase 1 and Cardiovascular Risk in Nephrotic Syndrome Patients

Background: Abnormal lipoprotein metabolism is a common characteristic of nephrotic syndrome. But this dyslipidemia cannot fully explain the increased incidence of atherosclerosis in this population. HDL associated enzyme, paraoxonase 1 (PON1), prevents the formation of oxidized LDL, which is an important culprit in the development of cardiovascular disease and therefore reduced PON1 is found to be an independent risk factor for atherosclerosis. Objective: The primary intention of this study is to analyze the PON1 levels in nephrotic syndrome along with lipid profile and atherogenic index, thus trying to provide a clearer picture of cardiovascular risk in nephrotic syndrome patients. Method: 40 newly diagnosed nephrotic syndrome patients were included in the study. Equal number of age and sex matched healthy controls were also selected. Basal and salt stimulated activity of PON1 was measured along with lipid profile and atherogenic index. Results: There was a significant decrease of PON1 activity in nephrotic syndrome patientscompared to the healthy controls. Total cholesterol, LDL, triglycerides, VLDLand Atherogenic Index were high and HDL cholesterol level was low in nephrotic syndrome patients. Moreover a significant negative correlation was observed between PON1 and Atherogenic index and a positive correlation between PON1 and HDL-cholesterol in both cases and controls. Conclusions: Therefore the study reveals an increased risk of cardiovascular disease in nephrotic syndrome patients. Hence measuring PON1and Atherogenic index during the initial stages of nephrotic syndrome mayhelp in predicting the extent of the associated cardiovascular risk.