| Summary: | 碩士 === 中山醫學大學 === 營養學系碩士班 === 106 === There are adverse clinical outcomes along with chronic kidney disease (CKD) progression, including of cardiovascular disease, stroke and hyperhomocysteinemia (homocysteine concentration ≥ 14 μmol/L). Elevated plasma homocysteine level may induce excessive production of reactive oxygen species through oxidation of homocysteine, leading to increased oxidative stress and decreased antioxidant enzyme activities (i.e., glutathione peroxidase). Hyperhomocysteinemia, increased oxidative stress, and decreased antioxidant capacities have been found to be associated with the risk of CKD. However, the associations of homocysteine with renal function, oxidative stress as well as antioxidant defense function have not been fully examined in CKD patients. Therefore, the purpose of our study was to compare the differences of plasma homocysteine, oxidative stress and antioxidant capacities among stage 1-5 CKD; and additionally examined the associations of plasma homocysteine with renal function, oxidative stress and antioxidant capacities in patients with CKD. This was a cross-sectional study. One hundred forty-two stage 1-5 CKD patients were recruited from the nephrology outpatient clinics of the Taichung Veterans General Hospital, Taichung, Taiwan. Patients had plasma homocysteine concentration ≥ 14 μmol/L were assigned to the hyperhomocysteinemia group, while patients had plasma homocysteine concentration <14 μmol/L were assigned to normo-homocysteinemia group. Results showed that decreased renal function [i.e., serum creatinine (β = 0.11, p < 0.001) and estimated glomerular filtration rate (β = -2.03, p < 0.001)] was associated with high plasma homocysteine concentration. There were no significant differences in oxidative stress indictors between two groups. However, patients with hyperhomocysteinemia had significantly higher levels of glutathione, but had significantly lower glutathione peroxidase activities compared with normmo-homocysteinemia patients. There were no significant association between levels of plasma homocysteine and oxidative stress indicators. However, plasma homocysteine level was significantly associated with glutathione peroxidase activity (β =-2.11 x 10⁻², p = 0.049) after adjusting for potential confounders. In conclusion, increased plasma homocysteine concentration were not only associated with decreased renal function, but also associated with decreased glutathione peroxidase activity in patients with CKD. However, plasma homocysteine was not associated with oxidative stress status.
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