Wilusz Małgorzata, Cieniawski Dominik, Wasilewski Grzegorz, Kuźniewski Marek, Sułowicz Władysław, Sztefko Krystyna
Department of Clinical Biochemistry, Jagiellonian University Medical College, University Children's Hospital of Cracow, Cracow, Poland.
Department of Nephrology, Jagiellonian University Medical College, Cracow, Poland.
Adv Med Sci. 2018 Sep;63(2):367-373. doi: 10.1016/j.advms.2018.04.010. Epub 2018 Aug 18.
Diabetes mellitus and hyperlipidemia are frequently observed after organ transplantation. It is known that in these disorders the fatty acid metabolism is impaired. The aim of this study was to compare the fatty acid profile in the heart and renal transplant recipients who developed metabolic disorders since there is no such research available.
The study included 55 patients treated with tacrolimus (Tac) after heart (n = 14; mean age: 60.4 ± 9.1) or renal (n = 41; mean age: 51 ± 13) transplantation. Diabetes and hyperlipidemia was present in 35.7% and 28.5% of heart transplant recipients, and 19.5% and 41% of renal transplant recipients. Concentrations of fatty acid in phospholipids fraction in serum were measured by gas chromatography.
The concentration of C20:5 fatty acid was lower in heart transplant recipients, as compared to renal transplant recipients (p = 0.001), whereas the level of C20+C18:3 fatty acid and the ratio of n-6/n-3 was higher (p = 0.01; p = 0.03, respectively). The observed differences were not related to metabolic disorders. Negative correlation between C16:1 and eGFR was seen in heart transplant recipients (p = 001). In renal transplant recipients with metabolic disorders, the concentration of C20:5 was correlated positively whereas the n-6/n-3 ratio was correlated negatively with eGFR (p < 0.001, p = 0.01, respectively). Hyperlipidemic renal transplant recipients had higher concentration of C20:2 (p = 0.02), C20:4 (p = 0.05), n-6 (0.04) and total fatty acid (p = 0.01) than patients without metabolic disorders.
The fatty acid profile differs depending on the transplanted organ, but the differences are not related to the metabolic disorders. The role of fatty acid in kidney function varies between heart transplant recipients and renal transplant recipients and depends on type of fatty acid.
器官移植后常出现糖尿病和高脂血症。已知在这些疾病中脂肪酸代谢受损。本研究的目的是比较心脏和肾移植受者发生代谢紊乱后的脂肪酸谱,因为尚无此类研究。
本研究纳入了55例心脏(n = 14;平均年龄:60.4±9.1)或肾(n = 41;平均年龄:51±13)移植后接受他克莫司(Tac)治疗的患者。心脏移植受者中糖尿病和高脂血症的发生率分别为35.7%和28.5%,肾移植受者中分别为19.5%和41%。采用气相色谱法测定血清磷脂组分中脂肪酸的浓度。
与肾移植受者相比,心脏移植受者中C20:5脂肪酸浓度较低(p = 0.001),而C20+C18:3脂肪酸水平和n-6/n-3比值较高(分别为p = 0.01;p = 0.03)。观察到的差异与代谢紊乱无关。心脏移植受者中C16:1与估算肾小球滤过率(eGFR)呈负相关(p = 0.01)。在有代谢紊乱的肾移植受者中,C20:5浓度与eGFR呈正相关,而n-6/n-3比值与eGFR呈负相关(分别为p < 0.001,p = 0.01)。高脂血症肾移植受者的C20:2(p = 0.02)、C20:4(p = 0.05)、n-6(0.04)和总脂肪酸(p = 0.01)浓度高于无代谢紊乱的患者。
脂肪酸谱因移植器官而异,但差异与代谢紊乱无关。脂肪酸在心脏移植受者和肾移植受者的肾功能中的作用不同,且取决于脂肪酸的类型。