O'Donnell M P, Kasiske B L, Kim Y, Schmitz P G, Keane W F
Department of Medicine, Hennepin County Medical Center, Minneapolis, MN.
Am J Kidney Dis. 1993 Jul;22(1):83-9. doi: 10.1016/s0272-6386(12)70172-5.
Considerable experimental evidence indicates that hyperlipidemia can induce glomerular injury. The importance of lipids in the progression of established glomerular disease has not been established and is of clinical relevance because of the frequent association of lipid abnormalities with human renal disease. In the present study, 26-week-old hyperlipidemic obese Zucker rats (OZRs) with established nephropathy were treated for a period of 18 weeks with daily injections of the cholesterol synthesis inhibitor lovastatin (4 mg/kg). Compared with control OZRs treated with vehicle, lovastatin-treated OZRs had significantly (P < 0.05) lower serum cholesterol and triglyceride levels throughout the treatment period. Blood pressure and urine albumin excretion in lovastatin-treated OZRs were reduced over the first 12 weeks of therapy, but increased toward the levels in the control OZRs at the end of the protocol. After 18 weeks of therapy, the incidence of glomerulosclerosis in lovastatin-treated OZRs (23.2% +/- 5.8%) was approximately half of that in vehicle-treated OZRs (44.6% +/- 7.7%) (P < 0.05). The reduction in glomerular injury in lovastatin-treated OZRs was not associated with changes in either glomerular area or glomerular macrophage content. In separate experiments, mesangial cells were cultured from glomeruli isolated from 26-week-old proteinuric OZRs. Lovastatin (5 to 40 mumol/L) caused a significant dose-dependent inhibition of serum-stimulated mesangial cell DNA synthesis. The inhibitory effects of lovastatin were completely prevented in the presence of exogenous mevalonate (100 mumol/L). Thus, lovastatin retarded the progression of established glomerular disease in OZRs.(ABSTRACT TRUNCATED AT 250 WORDS)
大量实验证据表明高脂血症可诱发肾小球损伤。脂质在已确诊的肾小球疾病进展中的重要性尚未明确,鉴于脂质异常与人类肾脏疾病频繁相关,这具有临床相关性。在本研究中,对患有肾病的26周龄高脂血症肥胖 Zucker 大鼠(OZRs)每日注射胆固醇合成抑制剂洛伐他汀(4 mg/kg),治疗18周。与用赋形剂处理的对照OZRs相比,洛伐他汀处理的OZRs在整个治疗期间血清胆固醇和甘油三酯水平显著降低(P < 0.05)。洛伐他汀处理的OZRs的血压和尿白蛋白排泄在治疗的前12周有所降低,但在方案结束时升高至对照OZRs的水平。治疗18周后,洛伐他汀处理的OZRs中肾小球硬化的发生率(23.2% +/- 5.8%)约为赋形剂处理的OZRs(44.6% +/- 7.7%)的一半(P < 0.05)。洛伐他汀处理的OZRs中肾小球损伤的减少与肾小球面积或肾小球巨噬细胞含量的变化无关。在单独的实验中,从26周龄蛋白尿OZRs分离的肾小球中培养系膜细胞。洛伐他汀(5至40 μmol/L)对血清刺激的系膜细胞DNA合成产生显著的剂量依赖性抑制。在存在外源性甲羟戊酸(100 μmol/L)的情况下,洛伐他汀的抑制作用完全被阻止。因此,洛伐他汀延缓了OZRs中已确诊的肾小球疾病的进展。(摘要截断于250字)