Department of Clinical Laboratory Medicine, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan.
Clin Chim Acta. 2010 Nov 11;411(21-22):1723-7. doi: 10.1016/j.cca.2010.07.016. Epub 2010 Jul 21.
Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) often have inflammation and dyslipidemia that accelerate to atherosclerosis. This study aimed to evaluate chronic inflammation and dyslipidemia in CAPD patients.
We measured inflammatory markers and lipoprotein subclasses in 20 CAPD patients (12 men and 8 women, aged 59.5 ± 9.9 y) and 20 gender-matched controls. Lipoproteins were separated by high-performance liquid chromatography (HPLC) using an anion-exchange column.
High-sensitivity C-reactive protein and serum amyloid A protein (SAA) were higher among CAPD patients vs. controls (1.6 ± 2.2 vs. 0.8 ± 1.2 mg/l, p<0.05; 11.9 ± 12.8 vs. 4.5 ± 2.4 mg/l). HPLC analysis revealed that chylomicron, VLDL, and IDL cholesterol levels were higher among CAPD vs. controls. In contrast, HDL cholesterol was lower among CAPD patients vs. controls. In the subgroup analysis, SAA levels were significantly lower among patients receiving CAPD for >3 y than among controls. However, IDL cholesterol was consistently higher among CAPD patients vs. controls.
CAPD patients have chronic inflammation and dyslipidemia. IDL cholesterol is the only lipoprotein subclass that is consistently elevated regardless of CAPD duration. More attention should be paid to dyslipidemia in the management of the CAPD patients.
接受持续不卧床腹膜透析(CAPD)的患者常伴有炎症和脂代谢紊乱,从而加速动脉粥样硬化的发生。本研究旨在评估 CAPD 患者的慢性炎症和脂代谢紊乱。
我们测量了 20 名 CAPD 患者(12 名男性,8 名女性,年龄 59.5±9.9 岁)和 20 名性别匹配的对照组患者的炎症标志物和脂蛋白亚类。采用阴离子交换柱高效液相色谱法(HPLC)分离脂蛋白。
与对照组相比,CAPD 患者的高敏 C 反应蛋白和血清淀粉样蛋白 A 蛋白(SAA)更高(1.6±2.2 比 0.8±1.2mg/L,p<0.05;11.9±12.8 比 4.5±2.4mg/L)。HPLC 分析显示,与对照组相比,CAPD 患者的乳糜微粒、VLDL 和 IDL 胆固醇水平更高。相反,CAPD 患者的 HDL 胆固醇水平低于对照组。在亚组分析中,与对照组相比,接受 CAPD 治疗>3 年的患者的 SAA 水平显著降低。然而,IDL 胆固醇在 CAPD 患者中始终高于对照组。
CAPD 患者存在慢性炎症和脂代谢紊乱。IDL 胆固醇是唯一一种无论 CAPD 持续时间如何都持续升高的脂蛋白亚类。在 CAPD 患者的管理中,应更加关注脂代谢紊乱。