Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Nephrology (Carlton). 2011 Jul;16(5):511-7. doi: 10.1111/j.1440-1797.2011.01456.x.
There is little data on the prevalence and severity of dyslipidaemia in Asian patients with lupus nephritis (LN). Whether the dyslipidaemia in LN patients differs from subjects with comparable levels of renal impairment also remains undefined.
Lipid profiles of 100 Chinese patients with quiescent LN (age 46.3 ± 9.3 years, 83% female, maintenance prednisolone dose 5.80 ± 2.43 mg/day) were studied and compared with 100 controls who had non-lupus non-diabetic chronic kidney diseases (CKD), matched for sex, age and renal function.
LN patients and CKD controls had similar renal function and proteinuria, while blood pressure was higher in controls. Twenty-five percent of LN patients and 17% of controls were receiving statin treatment. Despite this, 59% of LN patients and 46% CKD controls showed abnormal lipid parameters (P = 0.066). LN patients showed higher levels of total cholesterol (TC) and triglycerides (TG) than controls (5.28 ± 0.12 vs 4.86 ± 0.08 mmol/L, P = 0.004; and 1.62 ± 0.12 vs 1.20 ± 0.07 mmol/L, P = 0.002, respectively). More LN patients had abnormal TC, TG or low-density lipoprotein cholesterol (LDL-C) (54%, 16% and 38%; P = 0.016, = 0.005 and = 0.021, respectively). Hydroxychloroquine (HCQ) treatment was associated with lower TC, LDL-C and HDL-cholesterol.
Dyslipidaemia is prevalent in LN patients and is more severe than controls with a similar degree of CKD despite disease quiescence, low steroid dose and low level of proteinuria. Concomitant corticosteroid and renal impairment are likely contributing factors. HCQ treatment is associated with reduced severity of dyslipidaemia in LN patients.
亚洲狼疮肾炎 (LN) 患者血脂异常的流行率和严重程度数据较少。LN 患者的血脂异常是否与肾功能相当的患者不同也尚未明确。
研究了 100 例中国静止性 LN 患者（年龄 46.3±9.3 岁，83%为女性，维持泼尼松剂量 5.80±2.43mg/天）的血脂谱，并与 100 例具有非狼疮非糖尿病慢性肾脏病 (CKD)、性别、年龄和肾功能匹配的对照组进行比较。
LN 患者和 CKD 对照组的肾功能和蛋白尿相似，而对照组的血压较高。25%的 LN 患者和 17%的对照组正在接受他汀类药物治疗。尽管如此，59%的 LN 患者和 46%的 CKD 对照组的血脂参数异常（P=0.066）。与对照组相比，LN 患者的总胆固醇（TC）和甘油三酯（TG）水平更高（5.28±0.12 比 4.86±0.08mmol/L，P=0.004；1.62±0.12 比 1.20±0.07mmol/L，P=0.002）。更多的 LN 患者存在 TC、TG 或低密度脂蛋白胆固醇（LDL-C）异常（54%、16%和 38%；P=0.016、=0.005 和 =0.021）。羟氯喹（HCQ）治疗与 TC、LDL-C 和 HDL-胆固醇降低相关。
尽管疾病静止、低剂量皮质类固醇和低蛋白尿水平，LN 患者仍存在血脂异常且比 CKD 相似程度的对照组更严重。皮质类固醇和肾功能不全可能是促成因素。HCQ 治疗与 LN 患者血脂异常严重程度降低相关。
