Soltani Adele, Argani Hassan, Soleimani Fateme, Rahimipour Hooman, Akbarzadeh-Baghban Alireza, Azizi Tabassom, Kazerouni Faranak, Farshchian Fateme
From the Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Tehran, Iran.
Exp Clin Transplant. 2015 Dec;13(6):524-8. doi: 10.6002/ect.2014.0221. Epub 2015 Jun 15.
Disturbances in metabolism of lipo-proteins and oxidative modification of low-density lipoprotein contribute to cardiovascular disease and development of oxidative stress in patients under renal replacement therapy (hemodialysis and renal transplant). This study was designed to compare oxidized low-density lipoprotein levels and lipid profiles in renal transplant recipients and hemo-dialysis patients.
We investigated the concentration of oxidized low-density lipoprotein in hemodialysis (n = 38) and renal transplant (n = 59) patients who had no active inflammatory disease, liver disease, or malignancy, and results were compared to a control group (n = 30).
Renal transplant recipients had hypercholesterolemia, hypertriglyceridemia, and increased oxidized low-density lipoprotein levels (P = .019) compared with the control group. Hemodialysis patients had moderate hypertriglyceridemia (not significant), hypercholesterolemia, decrease in high-density lipoprotein, and increase in oxidized low-density lipoprotein levels (P < .0001) compared with the control group. In the renal transplant group, oxidized low-density lipoprotein level had a negative correlation with the duration after transplant (r = -0.407; P = .026), positive association with cyclosporine level (r = 0.288; P = .04), and negative correlation with high-density lipoprotein level (r = -.30; P = .05); oxidized low-density lipo-protein/high-density lipoprotein ratio also had a positive correlation with cyclosporine level (r = 0.309; P = .027) and negative correlation with high-density lipoprotein level (r = -0.72; P < .001) in the renal transplant group and high-density lipoprotein in the hemodialysis group (r = -0.87; P < .001). Multiple stepwise regression analyses showed that oxidized low-density lipoprotein only was associated with cyclosporine level (R2 = 0.155; β=0.393; P = .024).
History of cardiovascular disease is the most important factor associated with end-stage renal disease, and high oxidized low-density lipoprotein level, oxidized low-density lipo-protein/high-density lipoprotein ratio, and high-density lipoprotein level may affect cardiovascular disease.
脂蛋白代谢紊乱及低密度脂蛋白的氧化修饰会导致接受肾脏替代治疗(血液透析和肾移植)的患者发生心血管疾病并出现氧化应激。本研究旨在比较肾移植受者和血液透析患者中氧化型低密度脂蛋白水平及血脂谱。
我们调查了无活动性炎症疾病、肝脏疾病或恶性肿瘤的血液透析患者(n = 38)和肾移植患者(n = 59)的氧化型低密度脂蛋白浓度,并将结果与对照组(n = 30)进行比较。
与对照组相比,肾移植受者存在高胆固醇血症、高甘油三酯血症,且氧化型低密度脂蛋白水平升高(P = 0.019)。与对照组相比,血液透析患者有中度高甘油三酯血症(无统计学意义)、高胆固醇血症、高密度脂蛋白降低,且氧化型低密度脂蛋白水平升高(P < 0.0001)。在肾移植组中,氧化型低密度脂蛋白水平与移植后持续时间呈负相关(r = -0.407;P = 0.026),与环孢素水平呈正相关(r = 0.288;P = 0.04),与高密度脂蛋白水平呈负相关(r = -0.30;P = 0.05);在肾移植组中,氧化型低密度脂蛋白/高密度脂蛋白比值也与环孢素水平呈正相关(r = 0.309;P = 0.027),与高密度脂蛋白水平呈负相关(r = -0.72;P < 0.001),在血液透析组中与高密度脂蛋白呈负相关(r = -0.87;P < 0.001)。多元逐步回归分析显示,仅氧化型低密度脂蛋白与环孢素水平相关(R2 = 0.155;β = 0.393;P = 0.024)。
心血管疾病史是与终末期肾病相关的最重要因素,氧化型低密度脂蛋白水平升高、氧化型低密度脂蛋白/高密度脂蛋白比值升高以及高密度脂蛋白水平可能会影响心血管疾病。