Department of Laboratory Diagnostics, Medical University of Lublin, ul. Chodźki 1, Lublin, Poland.
J Zhejiang Univ Sci B. 2011 May;12(5):365-71. doi: 10.1631/jzus.B1000348.
Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed (HD) and post-renal transplant (Tx) patients are proatherogenic, but elevated concentrations of plasma high-density lipoprotein (HDL) reduce the risk of cardiovascular disease. We investigated the concentrations of lipid, lipoprotein, HDL particle, oxidized low-density lipoprotein (ox-LDL) and anti-ox-LDL, and paraoxonase-1 (PON-1) activity in HD (n=33) and Tx (n=71) patients who were non-smokers without active inflammatory disease, liver disease, diabetes, or malignancy. HD patients had moderate hypertriglyceridemia, normocholesterolemia, low HDL-C, apolipoprotein A-I (apoA-I) and HDL particle concentrations as well as PON-1 activity, and increased ox-LDL and anti-ox-LDL levels. Tx patients had hypertriglyceridemia, hypercholesterolemia, moderately decreased HDL-C and HDL particle concentrations and PON-1 activity, and moderately increased ox-LDL and anti-ox-LDL levels as compared to the reference, but ox-LDL and anti-ox-LDL levels and PON-1 activity were more disturbed in HD patients. However, in both patient groups, lipid and lipoprotein ratios (total cholesterol (TC)/HDL-C, LDL-C/HDL-C, triglyceride (TG)/HDL-C, HDL-C/non-HDL-C, apoA-I/apoB, HDL-C/apoA-I, TG/HDL) were atherogenic. The Spearman's rank coefficient test showed that the concentration of ox-LDL correlated positively with HDL particle level (R=0.363, P=0.004), and negatively with TC (R=-0.306, P=0.012), LDL-C (R=-0.283, P=0.020), and non-HDL-C (R=-0.263, P=0.030) levels in Tx patients. Multiple stepwise forward regression analysis in Tx patients demonstrated that ox-LDL concentration, as an independent variable, was associated significantly positively with HDL particle level. The results indicated that ox-LDL and decreased PON-1 activity in Tx patients may give rise to more mildly-oxidized HDLs, which are less stable, easily undergo metabolic remodeling, generate a greater number of smaller pre-β-HDL particles, and thus accelerate reverse cholesterol transport, which may be beneficial for Tx patients. Further studies are necessary to confirm this.
脂蛋白谱代谢紊乱和氧化应激在血液透析（HD）和肾移植后（Tx）患者中是动脉粥样硬化的致病因素，但血浆高密度脂蛋白（HDL）浓度的升高降低了心血管疾病的风险。我们研究了非吸烟、无活动性炎症性疾病、肝病、糖尿病或恶性肿瘤的 HD（n=33）和 Tx（n=71）患者的血脂、脂蛋白、HDL 颗粒、氧化型低密度脂蛋白（ox-LDL）和抗 ox-LDL 以及对氧磷酶-1（PON-1）活性的浓度。HD 患者有中度高甘油三酯血症、正常胆固醇血症、低 HDL-C、载脂蛋白 A-I（apoA-I）和 HDL 颗粒浓度以及 PON-1 活性，并且 ox-LDL 和抗 ox-LDL 水平升高。Tx 患者与参考值相比，有高甘油三酯血症、高胆固醇血症、中度 HDL-C 和 HDL 颗粒浓度降低以及 PON-1 活性降低，并且中度增加 ox-LDL 和抗 ox-LDL 水平，但 ox-LDL 和抗 ox-LDL 水平和 PON-1 活性在 HD 患者中更为紊乱。然而，在这两个患者组中，脂质和脂蛋白比值（总胆固醇（TC）/HDL-C、LDL-C/HDL-C、甘油三酯（TG）/HDL-C、HDL-C/非 HDL-C、apoA-I/apoB、HDL-C/apoA-I、TG/HDL）均具有致动脉粥样硬化作用。Spearman 秩相关系数检验显示，Tx 患者 ox-LDL 浓度与 HDL 颗粒水平呈正相关（R=0.363，P=0.004），与 TC（R=-0.306，P=0.012）、LDL-C（R=-0.283，P=0.020）和非 HDL-C（R=-0.263，P=0.030）呈负相关。Tx 患者的多元逐步向前回归分析表明，ox-LDL 浓度作为一个独立变量，与 HDL 颗粒水平呈显著正相关。结果表明，Tx 患者 ox-LDL 和降低的 PON-1 活性可能导致更轻度氧化的 HDLs，这些 HDLs 不太稳定，容易发生代谢重塑，产生更多数量的较小前-β-HDL 颗粒，从而加速胆固醇逆向转运，这可能对 Tx 患者有益。需要进一步的研究来证实这一点。
