Sun X, Jones H, Joles J A, van Tol A, Kaysen G A
Department of Medicine, Department of Veterans Affairs Medical Center, Martinez, California 94553.
Am J Physiol. 1992 May;262(5 Pt 2):F755-61. doi: 10.1152/ajprenal.1992.262.5.F755.
The nephrotic syndrome results from altered glomerular permselectivity, causing urinary protein loss, reduced albumin concentration, oncotic pressure (pi), and hyperlipidemia. Hepatic lipid and apolipoprotein synthesis increases and lipoprotein catabolism decreases. Decreased lipoprotein catabolism follows the onset of proteinuria but is not associated with hereditary analbuminemia [Nagase analbuminemic rat (NAR)] if proteinuria is absent. We measured plasma apolipoproteins (apo) AI, B, and E levels, their mRNA concentrations in liver, and the transcription rate of each mRNA in rats with Heymann nephritis (HN) or NAR to determine which alterations occurred in NAR alone without proteinuria. Plasma apo AI, B, and E were increased in both HN and NAR. Cholesterol and apo AI were inversely proportional to pi and independent of urinary protein loss or the presence of albumin in plasma. In contrast, triglycerides (TGs) were significantly greater in HN and were increased out of proportion to apo B. The concentration of apo AI mRNA increased in liver of both HN and NAR as did apo AI transcription. Apo E mRNA increased in neither HN nor NAR, whereas apo B mRNA increased only in HN. Transcription of neither apo B nor E increased. Plasma apo AI levels are likely to be regulated transcriptionally at the level of protein synthesis, whereas plasma apo B and E levels are regulated either posttranscriptionally, at the level of protein catabolism, or at both sites. Lipoproteins rich in TG and poor in apo B appear after the development of proteinuria but not as a consequence of analbuminemia alone. The accumulation of TG-rich apo B containing lipoproteins in rats with HN may result from impaired lipolysis occurring as a consequence of proteinuria.
肾病综合征源于肾小球滤过屏障改变,导致尿蛋白丢失、白蛋白浓度降低、胶体渗透压(π)降低及高脂血症。肝脏脂质和载脂蛋白合成增加,脂蛋白分解代谢减少。脂蛋白分解代谢减少在蛋白尿出现后发生,但如果不存在蛋白尿,则与遗传性无白蛋白血症[长谷无白蛋白血症大鼠(NAR)]无关。我们测定了海曼肾炎(HN)大鼠或NAR大鼠的血浆载脂蛋白(apo)AI、B和E水平、它们在肝脏中的mRNA浓度以及每种mRNA的转录速率,以确定在无蛋白尿的NAR大鼠中单独发生了哪些改变。HN大鼠和NAR大鼠的血浆apo AI、B和E均升高。胆固醇和apo AI与π呈负相关,且与尿蛋白丢失或血浆中白蛋白的存在无关。相比之下,HN大鼠的甘油三酯(TGs)显著更高,且其升高与apo B不成比例。HN大鼠和NAR大鼠肝脏中apo AI mRNA的浓度均增加,apo AI转录也增加。HN大鼠和NAR大鼠中apo E mRNA均未增加,而apo B mRNA仅在HN大鼠中增加。apo B和E的转录均未增加。血浆apo AI水平可能在蛋白质合成水平受到转录调控,而血浆apo B和E水平则在转录后水平、蛋白质分解代谢水平或两个位点均受到调控。富含TG且apo B含量低的脂蛋白在蛋白尿出现后出现,但并非仅由无白蛋白血症导致。HN大鼠中富含TG的含apo B脂蛋白的蓄积可能是由于蛋白尿导致脂解受损所致。