Argani H, Ghorbanihaghjo A, Rashtchizadeh N, Rahbaninobar M
Nephrology Division of Emam Hospital, Tabriz University of Medical Sciences.
Transplant Proc. 2005 Sep;37(7):2925-8. doi: 10.1016/j.transproceed.2005.07.045.
Increased serum lipoprotein(a) is an independent risk factor for atherosclerosis in renal transplant recipients. Higher levels may be due to genetic factors, for example, apolipoprotein A isoforms and/or environmental states such as drugs and diets. We evaluated 75 renal transplant recipients including 30 men and 45 women of overall mean age of 30 +/- 7 years and transplantation duration of 57 +/- 10 months as well as 30 healthy controls for apolipoprotein A isoforms, lipoprotein(a) concentrations, serum triglycerides, serum cholesterol, serum creatinine, and serum homocysteine concentrations. High- and low-molecular-weight apolipoprotein A isoforms (>35 and <35 kringle 4) were observed in 71% and 29% of renal transplant recipients and 83% and 17% of controls. Average lipoprotein(a) concentration ratios between high- and low-molecular-weight apolipoprotein A isoenzymes were significantly greater in renal transplant recipients than in controls. Lipoprotein A and cholesterol concentrations that did not correlate with each other were not higher among the eight renal transplant recipients with creatinine levels greater than 1.8 mg/dL. Absolute levels in renal transplant recipients with failed grafts also were not different regarding the various apolipoprotein A phenotypes. Homocysteine levels were significantly higher with high-molecular-weight apolipoprotein A isoenzymes. A relationship existed between lipoprotein(a) and triglycerides, but not cholesterol: higher triglyceride levels were associated more with high-molecular-weight isoforms of apolipoprotein A (P = .027). Lipoprotein(a) concentrations are higher in low-molecular-weight isoforms of apolipoprotein but triglyceride levels and homocysteine concentrations are higher among the high-molecular-weight isoforms of apolipoprotein A. This finding could be used as a guideline to select the most appropriate drug for different apolipoprotein A isoforms.
血清脂蛋白(a)升高是肾移植受者动脉粥样硬化的独立危险因素。其水平升高可能归因于遗传因素，如载脂蛋白A异构体，和/或环境因素，如药物和饮食。我们评估了75例肾移植受者，包括30名男性和45名女性，总体平均年龄为30±7岁，移植时间为57±10个月，还评估了30名健康对照者的载脂蛋白A异构体、脂蛋白(a)浓度、血清甘油三酯、血清胆固醇、血清肌酐和血清同型半胱氨酸浓度。在71%的肾移植受者和29%的对照者中观察到高分子量和低分子量载脂蛋白A异构体(>35和<35个kringle 4)，在83%的对照者和17%的对照者中也观察到。肾移植受者中高分子量和低分子量载脂蛋白A同工酶之间的平均脂蛋白(a)浓度比显著高于对照者。在8例肌酐水平大于1.8 mg/dL的肾移植受者中，彼此不相关的脂蛋白A和胆固醇浓度并不更高。移植失败的肾移植受者中各种载脂蛋白A表型的绝对水平也没有差异。同型半胱氨酸水平在高分子量载脂蛋白A同工酶中显著更高。脂蛋白(a)与甘油三酯之间存在关系，但与胆固醇无关：较高的甘油三酯水平与载脂蛋白A的高分子量异构体更相关(P = 0.027)。载脂蛋白低分子量异构体中的脂蛋白(a)浓度较高，但载脂蛋白A高分子量异构体中的甘油三酯水平和同型半胱氨酸浓度较高。这一发现可作为为不同载脂蛋白A异构体选择最合适药物的指导原则。
