Gullulu Mustafa, Kahvecioglu Serdar, Dirican Melahat, Akdag Ibrahim, Ocak Nihal, Demircan Celalettin, Dilek Kamil, Ersoy Alpaslan, Yavuz Mahmut, Yurtkuran Mustafa
Department of Nephrology, University Medical School, Bursa, Turkey.
Ren Fail. 2007;29(4):433-9. doi: 10.1080/08860220701278216.
Cardiovascular disease is the most common cause of morbidity and mortality in patients with chronic renal failure. Glomerulonephritic patients have an increased risk for cardiovascular disease, but its etiology is unclear. It is known that an increase in oxidizability of apolipoprotein B-containing lipoproteins has a key role in the initiation of atherosclerosis, and paraoxonase enzyme activity particularly has a preventive role against atherosclerosis. The aim of the present study was to evaluate the oxidizability of apolipoprotein B-containing lipoproteins, serum, and urinary paraoxonase/arylesterase activities in glomerulonephritis patients who had normal lipid parameters and creatinine levels.
Thirty-two patients with glomerulonephritis and 22 healthy controls were included in this study. A total of 32 patients (including nine with membranous GN, eight with immunoglobulin A nephropathy, eight with mesangial proliferative GN, five with focal-segmental glomerulosclerosis, one with diffuse proliferative GN, and one with minimal chance disease having biopsy proven GN) were enrolled into the study. We compared serum and urinary paraoxonase, arylesterase, serum lipids, urea, creatinine, hemoglobin, total protein and albumin values between groups.
Serum urea, creatinine, total protein, albumin, uric acid, hemoglobin, and lipid parameters were similar in the glomerulonephritis and control groups (p > 0.05). PON1 activity was significantly lower in GN group than controls, but there was no statistically significant difference on arylesterase activity between groups. Oxidizability of apolipoprotein B-containing lipoproteins was significantly higher in GN group than controls.
Our study shows that the findings of normal serum levels of creatinine, lipids, and proteins increased the oxidizability of apolipoprotein B-containing lipoproteins, and any decrease in PON1 activity in patients diagnosed with GN should be considered important. Hence, the immediate commencement of preventive as well as curative treatment in other to avoid the risk of cardiovascular and renal problems would be a correct approach.
心血管疾病是慢性肾衰竭患者发病和死亡的最常见原因。肾小球肾炎患者患心血管疾病的风险增加，但其病因尚不清楚。已知含载脂蛋白B的脂蛋白氧化能力增加在动脉粥样硬化的发生中起关键作用，尤其是对氧磷酶的酶活性对动脉粥样硬化具有预防作用。本研究的目的是评估脂质参数和肌酐水平正常的肾小球肾炎患者中含载脂蛋白B的脂蛋白的氧化能力、血清和尿对氧磷酶/芳基酯酶活性。
本研究纳入了32例肾小球肾炎患者和22例健康对照。共有32例患者（包括9例膜性肾小球肾炎、8例免疫球蛋白A肾病、8例系膜增生性肾小球肾炎、5例局灶节段性肾小球硬化、1例弥漫性增生性肾小球肾炎和1例经活检证实为肾小球肾炎的微小病变疾病）纳入研究。我们比较了两组之间的血清和尿对氧磷酶、芳基酯酶、血脂、尿素、肌酐、血红蛋白、总蛋白和白蛋白值。
肾小球肾炎组和对照组的血清尿素、肌酐、总蛋白、白蛋白、尿酸、血红蛋白和脂质参数相似（p>0.05）。肾小球肾炎组的对氧磷酶1活性显著低于对照组，但两组之间的芳基酯酶活性无统计学显著差异。肾小球肾炎组中含载脂蛋白B的脂蛋白的氧化能力显著高于对照组。
我们的研究表明，血清肌酐、脂质和蛋白质水平正常的结果增加了含载脂蛋白B的脂蛋白的氧化能力，对于诊断为肾小球肾炎的患者，对氧磷酶1活性的任何降低都应被视为重要。因此，立即开始预防和治疗以避免心血管和肾脏问题的风险将是正确的方法。
