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一项随机对照试验中尿酸对慢性肾脏病患者血脂水平的影响

Effects of Uric Acid on Lipid Levels in CKD Patients in a Randomized Controlled Trial.

作者信息

Bowden Rodney G, Shelmadine Brian D, Moreillon Jennifer J, Deike Erika, Griggs Jackson O, Wilson Ronald L

机构信息

Baylor University, Waco, TX, USA.

Texas Lutheran University, Austin, Texas, USA.

出版信息

Cardiol Res. 2013 Apr;4(2):56-63. doi: 10.4021/cr263w. Epub 2013 May 9.

Abstract

BACKGROUND

Few studies have been conducted that compared lipid levels and uric acid in CKD or End-Stage Renal Disease (ESRD) patients with most using animal models. The purpose of the study was to explore effects on lipids while controlling uric acid levels in CKD patients.

METHODS

Twenty-four CKD patients (N = 24) volunteered to participate in this study. The study was conducted using a double-blind, randomized, placebo controlled experimental protocol. The experimental group was prescribed 300 mg of allopurinol PO daily by their treating physician and followed prospectively for 8-weeks. The control group consumed a similar pill once a day for 8-weeks.

RESULTS

ANCOVA revealed significant differences in total cholesterol (P = 0.009) and Apo B (P = 0.006) with lower levels in the allopurinol group. A trend emerged with LDL (P = 0.052) with lower levels in the allopurinol group. No significant differences were discovered in triglycerides (P = 0.403), HDL (P = 0.762) and total Cholesterol/HDL Ratio (P = 0.455).

CONCLUSIONS

After statistically controlling for compliance and inflammation significant differences between groups were observed for total cholesterol and Apo B. In both instances the allopurinol group had lower concentrations than the placebo group. Similarly, a trend was observed in LDL with the allopurinol group having lower concentrations than the placebo group.

摘要

背景

很少有研究比较慢性肾脏病(CKD)或终末期肾病(ESRD)患者的血脂水平和尿酸,大多数研究使用动物模型。本研究的目的是在控制CKD患者尿酸水平的同时探索对血脂的影响。

方法

24名CKD患者自愿参与本研究。该研究采用双盲、随机、安慰剂对照实验方案进行。治疗医生为实验组患者每日口服300毫克别嘌醇,并进行为期8周的前瞻性随访。对照组连续8周每天服用类似的药丸。

结果

协方差分析显示,总胆固醇(P = 0.009)和载脂蛋白B(P = 0.006)存在显著差异,别嘌醇组水平较低。低密度脂蛋白(LDL)出现一种趋势(P = 0.052),别嘌醇组水平较低。甘油三酯(P = 0.403)、高密度脂蛋白(HDL)和总胆固醇/高密度脂蛋白比值(P = 0.455)未发现显著差异。

结论

在对依从性和炎症进行统计学控制后,观察到总胆固醇和载脂蛋白B在组间存在显著差异。在这两种情况下,别嘌醇组的浓度均低于安慰剂组。同样,在低密度脂蛋白方面也观察到一种趋势,别嘌醇组的浓度低于安慰剂组。

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