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Interaction between the Haptoglobin 2 Phenotype and Diabetes Mellitus on Systolic Pulmonary Arterial Pressure and Nitric Oxide Bioavailability in Hemodialysis Patients

Authors :
Inbal Dahan
Evgeny Farber
Nadia Thauho
Nakhoul Nakhoul
Adi Francis
Mohamad Awawde
Andrew P. Levy
Daniel B. Kim-Shapiro
Swati Basu
Farid Nakhoul
Source :
Journal of Diabetes Research, Vol 2015 (2015)
Publication Year :
2015
Publisher :
Hindawi Limited, 2015.

Abstract

Elevated systolic pulmonary artery pressure (s-PAP, ≥35 mmHg) serves as an independent predictor of mortality in hemodialysis (HD) and diabetic (DM) patients. A polymorphism in the antioxidant Haptoglobin (Hp) gene has been shown to regulate the bioavailability of nitric oxide (NO), a major mediator of pulmonary vascular tone. We therefore set out to test the hypothesis that the Hp polymorphism may be a determinant of developing elevated s-PAP specifically in the DM state due to a decreased bioavailability of NO. To test our hypothesis we Hp typed and performed transthoracic echocardiography on a series of HD patients and stratified them into elevated and normal s-PAP groups and then evaluated whether there was a significant association between the Hp type, elevated s-PAP, and decreased NO bioavailability as defined by low plasma nitrite. We found a statistically significant interaction between the Hp type and DM on the prevalence of elevated s-PAP and lower mean nitrite levels with the combination of elevated s-PAP and low nitrite levels being significantly more prevalent in Hp 2-2 DM individuals. We conclude that the Hp 2 type is associated with elevated s-PAP levels and low plasma nitrite levels in HD patients specifically in the DM state.

Details

Language :
English
ISSN :
23146745 and 23146753
Volume :
2015
Database :
Directory of Open Access Journals
Journal :
Journal of Diabetes Research
Publication Type :
Academic Journal
Accession number :
edsdoj.206e6e00561a4eb8a114bb4f26af05cc
Document Type :
article
Full Text :
https://doi.org/10.1155/2015/613860