Mordasini R, Frey F, Flury W, Klose G, Greten H
N Engl J Med. 1977 Dec 22;297(25):1362-6. doi: 10.1056/NEJM197712222972502.
To investigate the pathogenesis of hypertriglyceridemia in patients with renal disease we measured plasma lipoprotein composition as well as hepatic triglyceride lipase and lipoprotein lipase in post-heparin plasma. Three groups with renal disease were studied: conservatively treated chronic uremia; patients undergoing maintenance hemodialysis; and renal-allograft recipients. A selective decrease of hepatic triglyceride lipase with normal lipoprotein lipase was found in conservatively treated uremia and in patients undergoing hemodialysis. Elevated levels of very-low-density lipoproteins and increased triglycerides in low-density lipoproteins occurred in these patients. In contrast, hepatic triglyceride lipase and lipoprotein lipase were both normal in patients after renal transplantation who had Type II hyperlipoproteinemia as a common lipoprotein pattern with increased low-density-lipoprotein cholesterol and decreased high-density-lipoprotein cholesterol concentrations. The accumulation of a triglyceride-rich low-density lipoprotein in the majority of patients with renal disease may be the consequence of low hepatic triglyceride lipase.
为研究肾病患者高甘油三酯血症的发病机制，我们测定了肝素后血浆中的血浆脂蛋白组成以及肝甘油三酯脂肪酶和脂蛋白脂肪酶。研究了三组肾病患者：保守治疗的慢性尿毒症患者；接受维持性血液透析的患者；以及肾移植受者。在保守治疗的尿毒症患者和接受血液透析的患者中，发现肝甘油三酯脂肪酶选择性降低而脂蛋白脂肪酶正常。这些患者的极低密度脂蛋白水平升高，低密度脂蛋白中的甘油三酯增加。相比之下，肾移植后患有II型高脂蛋白血症的患者，其肝甘油三酯脂肪酶和脂蛋白脂肪酶均正常，其常见的脂蛋白模式为低密度脂蛋白胆固醇升高和高密度脂蛋白胆固醇浓度降低。大多数肾病患者中富含甘油三酯的低密度脂蛋白的积累可能是肝甘油三酯脂肪酶水平低的结果。
