Kimak Elzbieta, Ksiazek Andrzej, Baranowicz-Gaszczyk Iwona, Solski Janusz
Department of Laboratory Diagnostics, Medical University of Lublin, Poland.
Ren Fail. 2007;29(6):705-12. doi: 10.1080/08860220701460111.
Serum levels of lipids and lipoproteins were determined in 98 post-renal transplant fasting patients, and lipids and non-high density lipoprotein-cholesterol (non-HDL-C) and lipid ratios in the same post-renal transplant non-fasting patients were compared. The reference group was 87 healthy subjects. All patients were divided into two groups: patients with dyslipidemia (n = 69) and patients with normolipidemic (n = 29). The post-renal transplant patients (TX) with dyslipidemia had a significantly increased concentration of triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), non-HDL-C, apoB, and TRL and lipid ratios, and decreased HDL-C level and lipoprotein ratios. The lipids, lipoproteins, and lipoprotein ratios were significantly beneficial in TX patients with normolipidemic than in those with dyslipidemia. However, TRL concentration and lipid ratios were significantly increased and apoAI/apoCIII significantly decreased as compared to the reference group. The TX patients with dyslipidemia showed a significant correlation between TG and apoB:CIII (r = 0.562, p < 0.001) and apoCIII (r = 0.380, p < 0.004), but those with normolipidemic showed a significant correlation only between TG and apoCIII (r = 0.564, p < 0.008). Regression and Bland-Altman analyses showed excellent correlation between fasting and nonfasting non-HDL-C levels (r = 0.987, R(2) + 0.987) in TX patients both with dyslipidemia and normolipidemic. We think the finding that nonfasting labs that are reliable for non-HDL-C as well as total cholesterol is important, as fasting labs are not always available. Disturbances of lipids, lipoproteins, and TRLs depend not only on the kind of treatment, but due to multiple factors can accelerate cardiovascular complications in post-renal transplant patients with dyslipidemia and also with normolipidemic. Further studies concerning this problem should be completed.
对98例肾移植术后空腹患者测定了血清脂质和脂蛋白水平，并比较了同一批肾移植术后非空腹患者的脂质、非高密度脂蛋白胆固醇（non-HDL-C）及脂质比率。参照组为87名健康受试者。所有患者分为两组：血脂异常患者（n = 69）和血脂正常患者（n = 29）。肾移植术后血脂异常患者（TX）的甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、非HDL-C、载脂蛋白B（apoB）和乳糜微粒（TRL）浓度及脂质比率显著升高，高密度脂蛋白胆固醇（HDL-C）水平和脂蛋白比率降低。与血脂异常的TX患者相比，血脂正常的TX患者的脂质、脂蛋白及脂蛋白比率明显更有益。然而，与参照组相比，TRL浓度和脂质比率显著升高，载脂蛋白AI/载脂蛋白CIII显著降低。血脂异常的TX患者中，TG与apoB:CIII（r = 0.562，p < 0.001）和apoCIII（r = 0.380，p < 0.004）之间存在显著相关性，但血脂正常的患者中，仅TG与apoCIII之间存在显著相关性（r = 0.564，p < 0.008）。回归分析和布兰德-奥特曼分析显示，血脂异常和血脂正常的TX患者空腹和非空腹非HDL-C水平之间具有极好的相关性（r = 0.987，R(2)+0.987）。我们认为，对于非HDL-C以及总胆固醇而言，非空腹实验室检测结果可靠这一发现很重要，因为并非总能进行空腹检测。脂质、脂蛋白和TRL的紊乱不仅取决于治疗类型，而且由于多种因素，可加速肾移植术后血脂异常及血脂正常患者的心血管并发症。应完成关于该问题的进一步研究。
