de Gómez Dumm N T, Giammona A M, Touceda L A, Raimondi C
Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP-CONICET-UNLP), Argentina.
Medicina (B Aires). 2001;61(2):142-6.
Lipid abnormalities are common in patients with renal disease, probably contributing to the high incidence of cardiovascular diseases in this population. In this study we determined the plasma and erythrocyte lipid profile in patients with chronic renal failure (CRF) along 30 months under hemodialysis. In the same patients the influence of cuprophane and polysulfone dialysis membranes on the fatty acid pattern of plasma and erythrocytes, before and after dialysis, was also studied. Fluidity in erythrocyte membranes was also assessed by diphenylhexatriene (DPH) fluorescence polarization measurements. Triglyceride levels were increased in the plasma and in erythrocyte membranes of CRF patients compared to healthy subjects. Plasma polyunsaturared fatty acids decreased whereas palmitic and monounsaturated acids increased in CRF patients. No changes were observed in either the fatty acid profile or DPH fluorescence anisotropy of erythrocyte membranes. The lipid composition abnormalities persisted after 18 months and they became more notorious after 30 months. Neither the plasma nor the erythrocyte membrane lipid pattern changed in CRF patients during the dialysis session, regardless of the dialysis membrane used. We conclude that CRF patients under regular hemodialysis evidence a gradual deterioration in the fatty acid and triglyceride abnormalities, a finding that might be relevant to the risk of cardiovascular disease in this setting.
脂质异常在肾病患者中很常见,这可能是导致该人群心血管疾病高发的原因。在本研究中,我们测定了慢性肾衰竭(CRF)患者在血液透析30个月期间的血浆和红细胞脂质谱。在同一批患者中,还研究了铜仿膜和聚砜透析膜在透析前后对血浆和红细胞脂肪酸模式的影响。还通过二苯基己三烯(DPH)荧光偏振测量评估了红细胞膜的流动性。与健康受试者相比,CRF患者血浆和红细胞膜中的甘油三酯水平升高。CRF患者血浆中的多不饱和脂肪酸减少,而棕榈酸和单不饱和脂肪酸增加。红细胞膜的脂肪酸谱或DPH荧光各向异性均未观察到变化。脂质组成异常在18个月后持续存在,在30个月后变得更加明显。无论使用何种透析膜,CRF患者在透析过程中血浆和红细胞膜脂质模式均未改变。我们得出结论,定期血液透析的CRF患者的脂肪酸和甘油三酯异常逐渐恶化,这一发现可能与该情况下的心血管疾病风险相关。