Kimak Elzbieta, Solski Janusz, Baranowicz-Gaszczyk Iwona, Ksiazek Andrzej
Interfaculty Department of Laboratory Diagnostics, Medical University, Lublin, Poland.
Ren Fail. 2006;28(6):483-6. doi: 10.1080/08860220600778878.
Dyslipidemia is a major risk factor for atherosclerotic disease in renal transplant patients.
The serum levels of lipids and lipoproteins were determined in the same 12 post-renal transplant patients (TX) 10-29 and 73-122 months after transplantation. Thirteen healthy subjects--i.e., without diabetes, endocrine disease, liver disease, active inflammatory disease, glucose intolerance, malignancy, obesity, and urinary protein--were used as a reference group. TX patients had stable renal function. Twelve patients received cyclosporine A and prednisone, six received lovastatin, and one received rapa and prednisone. Lipids and lipoprotein (apo)AI and B were determined using Roche kits. An anti-apoB antibody was used to separate apoB-containing apoCIII and apoE lipoproteins as triglyceride-rich lipoproteins (TRLs) in the non-HDL fraction from apoCIIInonB and apoEnonB in the HDL fraction.
In both groups of post-renal transplant patients, a statistically significant increase of TG, TC, and non-HDL-C levels was observed. Moreover, statistically significant changes were shown in total apoCIII and apoCIIInonB, as well as in TG/HDL-C and apoAI/apoCIII ratios, as compared to the reference group. On the other hand, in TX patients 73-122 months after transplantation, significantly higher concentrations of TC, LDL-C, and especially non-HDL-C were observed. It was shown that apoCIII, apoCIIInonB, apoB:CIII, and lipid and lipoprotein ratios as risk factors of atherosclerosis and renal risk factors were higher in these patients 73-122 months after transplantation.
TX patients in a long-term study showed that they had disturbed lipoprotein composition, and its consequence was hyperlipidemia, perhaps partly due to the increased use of immunosuppressants and steroids.
血脂异常是肾移植患者动脉粥样硬化疾病的主要危险因素。
对12例肾移植术后患者在移植后10 - 29个月和73 - 122个月时测定血脂和脂蛋白的血清水平。选取13名健康受试者作为参照组，这些受试者无糖尿病、内分泌疾病、肝脏疾病、活动性炎症疾病、葡萄糖不耐受、恶性肿瘤、肥胖症及尿蛋白。肾移植患者肾功能稳定。12例患者接受环孢素A和泼尼松治疗，6例接受洛伐他汀治疗，1例接受雷帕霉素和泼尼松治疗。使用罗氏试剂盒测定血脂、脂蛋白（载脂蛋白）AI和B。使用抗载脂蛋白B抗体将非高密度脂蛋白（HDL）组分中含载脂蛋白B的载脂蛋白CIII和载脂蛋白E脂蛋白分离为富含甘油三酯的脂蛋白（TRL），将高密度脂蛋白（HDL）组分中的载脂蛋白CIIInonB和载脂蛋白EnonB分离出来。
在两组肾移植术后患者中，均观察到甘油三酯（TG）、总胆固醇（TC）和非高密度脂蛋白胆固醇（non - HDL - C）水平有统计学意义的升高。此外，与参照组相比，总载脂蛋白CIII和载脂蛋白CIIInonB以及TG/HDL - C和载脂蛋白AI/载脂蛋白CIII比值也有统计学意义的变化。另一方面，在移植后73 - 122个月的肾移植患者中，观察到TC、低密度脂蛋白胆固醇（LDL - C）尤其是non - HDL - C的浓度显著更高。结果显示，在移植后73 - 122个月的这些患者中，载脂蛋白CIII、载脂蛋白CIIInonB、载脂蛋白B: CIII以及脂质和脂蛋白比值作为动脉粥样硬化的危险因素和肾脏危险因素更高。
长期研究中的肾移植患者显示出脂蛋白组成紊乱，其结果是高脂血症，这可能部分归因于免疫抑制剂和类固醇使用的增加。
