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高载脂蛋白B血症:持续性非卧床腹膜透析治疗的慢性肾衰竭患者的主要血脂蛋白异常血症。

Hyperapobetalipoproteinemia: the major dyslipoproteinemia in patients with chronic renal failure treated with chronic ambulatory peritoneal dialysis.

作者信息

Sniderman A, Cianflone K, Kwiterovich P O, Hutchinson T, Barre P, Prichard S

出版信息

Atherosclerosis. 1987 Jun;65(3):257-64. doi: 10.1016/0021-9150(87)90041-4.

Abstract

In the present study, plasma cholesterol, triglyceride, low density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)-cholesterol, and the major protein in LDL, apoB, were measured in 28 patients with chronic renal failure treated with hemodialysis and in 28 patients with chronic renal failure treated with chronic ambulatory peritoneal dialysis (CAPD). Elevated plasma triglycerides and reduced HDL cholesterol were frequent in both the hemodialysis and CAPD patients. However LDL levels were significantly higher in the CAPD patients as evident both by LDL cholesterol and LDL apoB. Even so, only one of the CAPD patients was hypercholesterolemic whereas 14 (or 50%) had hyperapobetalipoproteinemia (HyperapoB). Insulin-dependent diabetes was more frequent in the CAPD group but only 2 of the 9 insulin-dependent diabetics in this group had HyperapoB, and therefore, diabetes mellitus cannot account for the difference between the 2 groups. Thus HyperapoB appears to be a prevalent dyslipoproteinemia in CAPD patients and as such might be another factor which places CAPD patients at particularly increased risk of atherosclerosis.

摘要

在本研究中,对28例接受血液透析治疗的慢性肾衰竭患者和28例接受持续性非卧床腹膜透析(CAPD)治疗的慢性肾衰竭患者的血浆胆固醇、甘油三酯、低密度脂蛋白(LDL)胆固醇、高密度脂蛋白(HDL)胆固醇以及LDL中的主要蛋白质载脂蛋白B进行了测量。血液透析患者和CAPD患者中均经常出现血浆甘油三酯升高和HDL胆固醇降低的情况。然而,无论是通过LDL胆固醇还是LDL载脂蛋白B来看,CAPD患者的LDL水平均显著更高。即便如此,CAPD患者中只有1例患有高胆固醇血症,而有14例(或50%)患有高载脂蛋白血症(HyperapoB)。CAPD组中胰岛素依赖型糖尿病更为常见,但该组9例胰岛素依赖型糖尿病患者中只有2例患有HyperapoB,因此,糖尿病不能解释两组之间的差异。由此可见,HyperapoB似乎是CAPD患者中普遍存在的一种脂蛋白异常血症,因此可能是使CAPD患者动脉粥样硬化风险特别增加的另一个因素。

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