Siirtola Arja, Ketomäki Anna, Miettinen Tatu A, Gylling Helena, Lehtimäki Terho, Holmberg Christer, Salo Matti K, Antikainen Marjatta
Pediatric Research Center, University of Tampere, Tampere, Finland.
Transplantation. 2006 Feb 15;81(3):327-34. doi: 10.1097/01.tp.0000189173.46727.18.
Hypercholesterolemia after organ transplantation is common. Previously, we observed higher serum total cholesterol (TC) concentrations in our pediatric kidney than liver or heart transplant recipients. To find an explanation to the observed difference, our kidney recipients' cholesterol synthesis and absorption efficiency was compared to those of liver and heart recipients.
Serum noncholesterol sterol ratios (10 x mmol to the mol of TC, surrogate estimates of hepatic cholesterol synthesis and intestinal absorption) were studied in 50 pediatric kidney, 25 liver and 12 heart transplant recipients without diabetes or cholestasis, and in 29 controls.
The kidney recipients had lower Delta-cholesterol (P=0.031), similar lathosterol and higher desmosterol ratios (markers of cholesterol synthesis) (P=0.020), and similar campesterol and sitosterol ratios (markers of cholesterol absorption) when compared to the controls. The liver recipients had lower campesterol ratios than the kidney recipients and controls (P=0.002). Glomerular filtration rates were not associated with the ratios of noncholesterol sterols. Multivariate analysis showed markers of cholesterol synthesis to be lower and absorption to be higher in the kidney than the liver or the heart transplant recipients. Weight-adjusted dosages of immunosuppressive agents were associated with some ratios of noncholesterol sterols and cholestanol though these varied between the transplant recipient groups.
Serum TC concentration in kidney recipients was not significantly associated with absorption efficiency or synthesis of cholesterol, though kidney transplantation was associated with low synthesis and high absorption efficiency of cholesterol. Immunosuppressive therapy with cyclosporine and methylprednisolone may modulate absorption efficiency and synthesis of cholesterol.
器官移植后高胆固醇血症很常见。此前，我们观察到儿科肾移植受者的血清总胆固醇（TC）浓度高于肝移植或心脏移植受者。为了找到对观察到的差异的解释，我们将肾移植受者的胆固醇合成和吸收效率与肝移植和心脏移植受者进行了比较。
在50名无糖尿病或胆汁淤积的儿科肾移植受者、25名肝移植受者和12名心脏移植受者以及29名对照中，研究了血清非胆固醇甾醇比率（每摩尔TC中10倍毫摩尔，肝胆固醇合成和肠道吸收的替代估计值）。
与对照组相比，肾移植受者的δ-胆固醇较低（P=0.031），羊毛甾醇相似，而胆甾烯醇比率较高（胆固醇合成标志物）（P=0.020）；菜油甾醇和谷甾醇比率（胆固醇吸收标志物）相似。肝移植受者的菜油甾醇比率低于肾移植受者和对照组（P=0.002）。肾小球滤过率与非胆固醇甾醇比率无关。多变量分析显示，肾移植受者的胆固醇合成标志物低于肝移植或心脏移植受者，而吸收标志物则较高。免疫抑制剂的体重调整剂量与一些非胆固醇甾醇和胆甾烷醇比率相关，尽管这些在移植受者组之间有所不同。
肾移植受者的血清TC浓度与胆固醇的吸收效率或合成无显著相关性，尽管肾移植与低胆固醇合成和高吸收效率相关。环孢素和甲泼尼龙的免疫抑制治疗可能会调节胆固醇的吸收效率和合成。
