Yang W Q, Song N G, Ying S S, Liang H Q, Zhang Y J, Wei M J, Wu K F
National Laboratory of Experimental Hematology, Chinese Academy of Medical Sciences, Tianjin, China.
Clin Lab Sci. 1999 Mar-Apr;12(2):104-8.
To explore the distribution pattern for serum lipid concentrations among patients with different degrees of chronic renal failure; to study the characteristics of abnormal lipid metabolism for chronic renal failure patients when the disease progress further.
No. 255 Hospital of PLA, Tangshan, Hebei, China; No. 281 Hospital of PLA, Beidanhe, Hebei, China; and the General Hospital of Beijing Military Region, Beijing, China.
A total of 240 serum/urine samples from 50 healthy volunteers and from 190 patients with different degrees of chronic renal failure, which fall into four groups according to their glomerular filtration rates, were measured for serum levels of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and for urine albumin concentrations; the levels of these criteria were compared between the control group and diseased groups; the mean concentrations of different lipid variables were paired and subjected to linear regression analysis.
Glomerular filtration rates were estimated by the iohexol clearance method, in which plasma content of iohexol was measured with high performance liquid chromatography; concentrations of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and albumin were assayed according to standard protocols.
Serum levels of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, and urine albumin contents were significantly higher, whereas those of high density lipoprotein cholesterol were lower, in diseased groups than that of the control (p < 0.05, p < 0.01). When the disease progressed, concentrations of these criteria increased or decreased further (p < 0.01, p < 0.05). Significant correlations were found between a few lipid criteria for their mean concentrations in diseased groups.
The study demonstrates a correlation between abnormalities of lipid metabolism and the degrees of kidney insufficiency, and a correlation within certain kinds of lipid criteria in patients with different degrees of renal damage. The results suggest the existence of multi-correlations in vivo in catabolism and metabolism of lipid, lipoprotein, apolipoprotein, and protein in the patients. The exact mechanism responsible for the association and correlation remains to be clarified.
探讨不同程度慢性肾衰竭患者血脂浓度的分布模式；研究慢性肾衰竭患者疾病进展时脂质代谢异常的特征。
中国河北唐山解放军第255医院；中国河北北戴河解放军第281医院；以及中国北京北京军区总医院。
对50名健康志愿者和190名不同程度慢性肾衰竭患者的240份血清/尿液样本进行检测，这些患者根据肾小球滤过率分为四组，检测血清甘油三酯、脂蛋白(a)、脂蛋白(a)胆固醇、总胆固醇、载脂蛋白A1、载脂蛋白B100、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平以及尿白蛋白浓度；比较对照组和疾病组这些指标的水平；对不同脂质变量的平均浓度进行配对并进行线性回归分析。
采用碘海醇清除率法估算肾小球滤过率，其中碘海醇的血浆含量用高效液相色谱法测定；甘油三酯、脂蛋白(a)、脂蛋白(a)胆固醇、总胆固醇、载脂蛋白A1、载脂蛋白B100、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和白蛋白的浓度按照标准方案进行检测。
疾病组血清甘油三酯、脂蛋白(a)、脂蛋白(a)胆固醇、总胆固醇、载脂蛋白A1、载脂蛋白B100、低密度脂蛋白胆固醇水平及尿白蛋白含量显著高于对照组，而高密度脂蛋白胆固醇水平低于对照组（p<0.05，p<0.01）。疾病进展时，这些指标的浓度进一步升高或降低（p<0.01，p<0.05）。疾病组中一些脂质指标的平均浓度之间存在显著相关性。
该研究表明脂质代谢异常与肾功能不全程度之间存在相关性，以及不同程度肾损害患者某些脂质指标之间存在相关性。结果提示患者体内脂质、脂蛋白、载脂蛋白和蛋白质的分解代谢和代谢存在多重相关性。这种关联和相关性的确切机制仍有待阐明。
