Giannarelli R, Coppelli A, Aragona M, Boggi U, Napoli V, Donadio F, Paleologo G, Tregnaghi C, Rizzo G, Mosca F, Del Prato S, Marchetti P
Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy.
Diabetes Nutr Metab. 2003 Aug;16(4):232-5.
The relationships between lipid levels and atherosclerotic lesions of carotid arteries in kidney graft recipients are still unclear.
We evaluated carotid morphology in 53 recipients of functioning renal transplantation, and studied the relationship of carotid artery wall lesions with relevant clinical and laboratory risk factors for cardiovascular disease. The patients were on stable, cyclosporine-based immunosuppressive therapy.
The main clinical characteristics of patients were: age, 46.5 +/- 10.1 years; males/females, 40/13; body mass index, 25.8 +/- 4.4 kg/m2; duration of transplantation, 43 +/- 52 months. Ultrasonographic scanning of carotid arteries showed the presence of lesions (intimal-media thickness and/or plaque) in 28 patients (52.8%). These recipients differed from patients without carotid lesions in terms of age (50.4 +/- 9.0 vs 42.2 +/- 9.7 years, p < 0.01) and duration of pre-transplant dialysis (4.6 +/- 3.4 vs 2.3 +/- 1.9 years, p < 0.01), whereas no statistically significant difference was observed as for total cholesterol (230 +/- 44 vs 235 +/- 35 mg/dl), LDL-cholesterol (142 +/- 32 vs 143 +/- 30 mg/dl), HDL-cholesterol (52 +/- 12 vs 58 +/- 20 mg/dl) and triglycerides (178 +/- 94 vs 167 +/- 89 mg/dl). The percentage of post-transplant diabetes was 3-fold higher in patients with carotid lesions (25 vs 8%). No difference was observed as for the following parameters: body mass index, duration of transplantation, fibrinogen levels, DDimer concentrations, reactive C-protein values, prevalence of hypertension, percentage of smokers vs non-smokers.
The present study supports the view that carotid artery lesions in kidney graft recipients on stable, cyclosporine-based immunosuppressive therapy may not be related to circulating lipid values.
肾移植受者的血脂水平与颈动脉粥样硬化病变之间的关系仍不明确。
我们评估了53例功能正常的肾移植受者的颈动脉形态，并研究了颈动脉壁病变与心血管疾病相关临床及实验室危险因素之间的关系。患者接受基于环孢素的稳定免疫抑制治疗。
患者的主要临床特征为：年龄46.5±10.1岁；男/女为40/13；体重指数25.8±4.4kg/m²；移植时间43±52个月。颈动脉超声扫描显示28例患者（52.8%）存在病变（内膜中层厚度和/或斑块）。这些受者与无颈动脉病变的患者在年龄（50.4±9.0岁对42.2±9.7岁，p<0.01）和移植前透析时间（4.6±3.4年对2.3±1.9年，p<0.01）方面存在差异，而总胆固醇（230±44对235±35mg/dl）、低密度脂蛋白胆固醇（142±32对143±30mg/dl）、高密度脂蛋白胆固醇（52±12对58±20mg/dl）和甘油三酯（178±94对167±89mg/dl）方面未观察到统计学显著差异。有颈动脉病变的患者移植后糖尿病的发生率高出3倍（25%对8%）。在以下参数方面未观察到差异：体重指数、移植时间、纤维蛋白原水平、D-二聚体浓度、反应性C蛋白值、高血压患病率、吸烟者与非吸烟者的比例。
本研究支持这样的观点，即接受基于环孢素的稳定免疫抑制治疗的肾移植受者的颈动脉病变可能与循环血脂值无关。
