Ghorbanihaghjo Amir, Argani Hassan, Rohbaninoubar Mohammad, Rashtchizadeh Nadereh
Department of Biochemistry, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Lipids Health Dis. 2004 Jun 29;3:16. doi: 10.1186/1476-511X-3-16.
Malnutrition, anemia and increased atherosclerosis are the main causes of mortality in hemodialysis patients. Therapies designed to improve the disorders might therefore be expected to improve outcome. The effects of Nandrolone Decanoate (ND), in 64 stable hemodialysis patients, were studied with respect to the following parameters: nutritional status, hematological indexes, lipid profiles including serum levels of lipoprotein(a) [Lp(a)] in terms of differences in apolipoprotein(a) [apo(a)]. The patients were treated with ND at dose of 100 mg/I.M./week for 4 months. After 2 and 4 months of treatment the elevations in the serum levels of albumin (p < 0.0001), creatinine (p < 0.009), hemoglobin (p < 0.03), hematocrit (p < 0.03), cholesterol (p = 0.007) and triglyceride (p < 0.04) were noticed. Marked decrease in the concentration of high-density lipoprotein cholesterol (p = 0.007) and Lp(a) (p < 0.0001) were also found. These effects after 2 months of treatment withdrawal were relatively constant. By dividing patients according to the baseline Lp(a) levels and molecular weight of apo(a) isoform, it was noticed that the decrease in serum Lp(a) was significant in patients with high Lp(a) (> 30 mg/dl) than those of with low Lp(a) (< 30 mg/dl), irrespective of apo(a) molecular weight. It may be suggested that, ND has beneficial effect on nutritional status and treatment of anemia in hemodialysis patients. In spite the adverse effect of ND on lipid profile, it decreases Lp(a) mostly in patients with high serum Lp(a) preferently by the effect on apo(a) gene transcriptional activity.
营养不良、贫血和动脉粥样硬化加剧是血液透析患者死亡的主要原因。因此，旨在改善这些病症的治疗方法有望改善患者预后。本研究在64例稳定的血液透析患者中，就以下参数研究了癸酸诺龙（ND）的作用：营养状况、血液学指标、血脂谱，包括根据载脂蛋白(a) [apo(a)]差异得出的血清脂蛋白(a) [Lp(a)]水平。患者接受剂量为100 mg/肌肉注射/周的ND治疗，为期4个月。治疗2个月和4个月后，观察到血清白蛋白水平升高（p < 0.0001）、肌酐升高（p < 0.009）、血红蛋白升高（p < 0.03）、血细胞比容升高（p < 0.03）、胆固醇升高（p = 0.007）和甘油三酯升高（p < 0.04）。还发现高密度脂蛋白胆固醇浓度显著降低（p = 0.007）和Lp(a)显著降低（p < 0.0001）。停药2个月后的这些影响相对稳定。根据基线Lp(a)水平和apo(a)异构体的分子量对患者进行分组后发现，无论apo(a)分子量如何，血清Lp(a)降低在Lp(a)水平高（> 30 mg/dl）的患者中比Lp(a)水平低（< 30 mg/dl）的患者更显著。可以认为，ND对血液透析患者的营养状况和贫血治疗有有益作用。尽管ND对血脂谱有不良影响，但它主要通过对apo(a)基因转录活性的作用，优先降低血清Lp(a)水平高的患者的Lp(a)。
