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单侧肾切除的雌性无白蛋白血症大鼠的蛋白尿、脂蛋白和肾载脂蛋白沉积

Proteinuria, lipoproteins and renal apolipoprotein deposits in uninephrectomized female analbuminemic rats.

作者信息

Joles J A, van Goor H, Braam B, Willekes-Koolschijn N, Jansen E H, van Tol A, Koomans H A

机构信息

Department of Nephrology and Hypertension, Utrecht University, The Netherlands.

出版信息

Kidney Int. 1995 Feb;47(2):442-53. doi: 10.1038/ki.1995.57.

Abstract

To elucidate the pathogenetic role of hyperlipidemia per se in the development of glomerulosclerosis, severely hyperlipidemic female analbuminemic rats (NAR) and mildly hyperlipidemic male NAR were studied for a period of 37 weeks after uninephrectomy (UNX). Plasma cholesterol increased from 6.3 +/- 0.4 (week 4) to 11.9 +/- 0.6 mmol/liter (week 37) in the female NAR, and from 4.3 +/- 0.1 to 6.4 +/- 0.5 mmol/liter in the male NAR in the same period. Plasma protein concentration was also consistently higher in female NAR (60 +/- 1 g/liter) as compared to male NAR (52 +/- 1 g/liter). Plasma viscosity was higher in female NAR than in male NAR, but there were no differences in blood viscosity. Proteinuria increased progressively in the UNX female NAR from 25 weeks after surgery, reaching a final value of 141 +/- 37 mg/day. No proteinuria occurred in the UNX male NAR (final value 15 +/- 2 mg/day). Glomerular capillary pressure, measured prior to the onset of proteinuria, was not significantly different in UNX female NAR and UNX male NAR. At the end of the study glomerulosclerosis and lipid deposition was only found in the UNX female NAR. Throughout the study hyperfiltration and hyperperfusion, relative to the one-kidney clearances of the sham-operated (2K) animals, were not different in UNX male and female NAR. No differences were observed in blood pressure. Hypertrophy, evaluated by glomerular diameters, was less pronounced in UNX female NAR (174 +/- 3 microns) than in UNX male NAR (190 +/- 7 microns). Glomerular diameters in 2K female and male NAR were similar (respectively 158 +/- 2 and 157 +/- 4 microns). Plasma apo B levels were similar (2K female NAR: 204 +/- 8 U; 2K male NAR 204 +/- 13 U), but cholesterol and triglyceride content of apo B-containing lipoproteins, namely VLDL, IDL and LDL, was increased twofold in the female NAR as compared to the male NAR, implying a larger particle size in the female NAR. Deposition of apo B and apo E was observed in the glomerular mesangium of UNX female NAR, particularly in sclerotic lesions. Glomerular apo A-I deposits were localized primarily in visceral epithelial cells and were not associated with sclerotic lesions. The development of proteinuria and glomerulosclerosis after UNX in female NAR but not in male NAR may depend upon differences in plasma lipoprotein composition, but is apparently not related to differences in whole kidney hyperfiltration and hyperperfusion, glomerular capillary pressure, or blood viscosity.

摘要

为阐明高脂血症本身在肾小球硬化发展中的致病作用,对单侧肾切除(UNX)后37周的重度高脂血症雌性无白蛋白血症大鼠(NAR)和轻度高脂血症雄性NAR进行了研究。雌性NAR的血浆胆固醇从(第4周)6.3±0.4 mmol/升增加到(第37周)11.9±0.6 mmol/升,同期雄性NAR的血浆胆固醇从4.3±0.1 mmol/升增加到6.4±0.5 mmol/升。雌性NAR的血浆蛋白浓度(60±1 g/升)也始终高于雄性NAR(52±1 g/升)。雌性NAR的血浆粘度高于雄性NAR,但血液粘度无差异。UNX雌性NAR术后25周蛋白尿逐渐增加,最终值达到141±37 mg/天。UNX雄性NAR未出现蛋白尿(最终值15±2 mg/天)。在蛋白尿出现之前测量的肾小球毛细血管压力,UNX雌性NAR和UNX雄性NAR之间无显著差异。研究结束时,仅在UNX雌性NAR中发现肾小球硬化和脂质沉积。在整个研究过程中,相对于假手术(2K)动物的单肾清除率,UNX雄性和雌性NAR的超滤和高灌注无差异。血压无差异。通过肾小球直径评估的肥大,在UNX雌性NAR(174±3微米)中比在UNX雄性NAR(190±7微米)中不明显。2K雌性和雄性NAR的肾小球直径相似(分别为158±2和157±4微米)。血浆载脂蛋白B水平相似(2K雌性NAR:204±8 U;2K雄性NAR 204±13 U),但含载脂蛋白B的脂蛋白(即极低密度脂蛋白、中间密度脂蛋白和低密度脂蛋白)的胆固醇和甘油三酯含量在雌性NAR中比雄性NAR增加了两倍,这意味着雌性NAR中的颗粒尺寸更大。在UNX雌性NAR的肾小球系膜中观察到载脂蛋白B和载脂蛋白E的沉积,特别是在硬化病变中。肾小球载脂蛋白A-I沉积物主要定位于脏层上皮细胞,且与硬化病变无关。UNX后雌性NAR而非雄性NAR出现蛋白尿和肾小球硬化,可能取决于血浆脂蛋白组成的差异,但显然与全肾超滤和高灌注、肾小球毛细血管压力或血液粘度的差异无关。

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