Association of Elevated Oxidized Low Density Lipoprotein to Low Density Lipoprotein Ratio (Ox LDL/LDL) with Sub Clinical Atherosclerosis in Patients Receiving Maintenance Haemodialysis

Objective: To assess the oxidized low density lipoprotein (ox-LDL) to low density lipoprotein (LDL) ratio as an indicator of subclinical atherosclerosis in haemodialysis patients Methodology: This case control study was carried out at Jinnah Post Graduate Medical Center Karachi, from January to December 2018. The haemodialysis patients were selected from the dialysis center (group B) whereas the controls were recruited from normal healthy population (group A). To access the status of atherosclerosis, doppler ultrasonography technique was employed to detect the intima media thickness (IMT) ratio of common carotid artery of study subjects as well as controls. Lipid peroxidation was detected by serum oxidized LDL (ox-LDL) levels. Results: The mean of carotid artery intima thickness in group A was 0.43±0.02, the mean intima thickness of group B samples was 1.0±0.09. The mean ratio of Ox-LDL/LDL in group A was 0.003±0.001. While in group B the mean of Ox-LDL: LDL was 0.012±0.002. Ox-LDL was found to have a positive linear relationship with mean carotid artery intima media thickness ratio (r=0.8) in haemodialysis group. Conclusion: Ox-LDL to LDL ratio is much enhanced in patients on maintenance haemodialysis showing increased lipid peroxidation. Ox-LDL has a positive linear relationship with mean carotid artery intima media thickness ratio which is a marker of sub clinical atherosclerosis. Early detection of elevated Ox-LDL will help nephrologists in early detection and treatment of sub clinical atherosclerosis.