Tinahones F J, Collantes E, C-Soriguer F J, González-Ruiz A, Pineda M, Añón J, Sánchez Guijo P
Sección de Endocrinologia, HR Carlos Haya de Málaga, Córdoba, Spain.
Br J Rheumatol. 1995 Oct;34(10):920-4. doi: 10.1093/rheumatology/34.10.920.
The objective was to study the lipoprotein levels in primary hyperuricaemic patients and to analyse their renal management or urates in order to check for some potential influence of altered lipid levels on the renal excretion of urates by this type of patient. Overall 115 male individuals were studied in five groups, namely: 30 primary hyperuricaemic (group I); 27 primary hyperuricaemic-hypercholesterolaemic (group II); nine primary hyperuricaemic-hypertriglyceridaemic (group III); 33 primary hyperuricaemic-mixed hyperlipidaemic (group IV); and 16 normouricaemic-normolipidaemic subjects (group C). All patients were subjected to blood analyses for uric acid, total triglycerides, total protein, creatinine, high density lipoprotein (HDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, low density lipoprotein (LDL) cholesterol, apoprotein (apo) AI, apoprotein B, apoprotein CII and apoproteins CIII1 and CIII2. For urine analysis creatinine, creatinine clearance, uric acid excretion, clearance and fractional excretion were measured in 24 h urine samples. Mixed and pure hyperuricaemic-hypertriglyceridaemic patients exhibited increased levels of VLDL components, decreased fractional excretion of uric acid and increased apo CIII/CII ratios. The increased levels of structural VLDL components were negatively (and statistically significantly) correlated with the fractional excretion of uric acid; this suggests a close biological relationship between the two parameters. Taking into account the role played by apo C in VLDL metabolism, the altered apo CIII/CII ratios found in hyperuricaemic-hypertriglyceridaemic patients (both pure and mixed) suggest that this apoprotein plays a central role in the physiopathology of the alterations observed.
目的是研究原发性高尿酸血症患者的脂蛋白水平，并分析其肾脏对尿酸盐的处理情况，以检查血脂水平改变对这类患者肾脏尿酸排泄的潜在影响。总共对115名男性个体进行了研究，分为五组，即：30名原发性高尿酸血症患者（第一组）；27名原发性高尿酸血症合并高胆固醇血症患者（第二组）；9名原发性高尿酸血症合并高甘油三酯血症患者（第三组）；33名原发性高尿酸血症合并混合型高脂血症患者（第四组）；以及16名尿酸正常血脂正常的受试者（对照组）。所有患者均接受血液分析，检测尿酸、总甘油三酯、总蛋白、肌酐、高密度脂蛋白（HDL）胆固醇、极低密度脂蛋白（VLDL）胆固醇、低密度脂蛋白（LDL）胆固醇、载脂蛋白（apo）AI、载脂蛋白B、载脂蛋白CII以及载脂蛋白CIII1和CIII2。对于尿液分析，在24小时尿液样本中测量肌酐、肌酐清除率、尿酸排泄、清除率和排泄分数。混合型和单纯性高尿酸血症合并高甘油三酯血症患者的VLDL成分水平升高，尿酸排泄分数降低，apo CIII/CII比值升高。结构性VLDL成分水平的升高与尿酸排泄分数呈负相关（且具有统计学意义）；这表明这两个参数之间存在密切的生物学关系。考虑到apo C在VLDL代谢中的作用，在高尿酸血症合并高甘油三酯血症患者（包括单纯性和混合型）中发现的apo CIII/CII比值改变表明，这种载脂蛋白在观察到的病变的病理生理学中起核心作用。
