Samuelsson O, Aurell M, Knight-Gibson C, Alaupovic P, Attman P O
Department of Nephrology, University of Göteborg, Sweden.
Nephron. 1993;63(3):279-85. doi: 10.1159/000187210.
Hyperlipidemia is associated with accelerated glomerular sclerosis in experimental renal insufficiency. To investigate whether the dyslipoproteinemia seen in human renal failure also influences the future course of renal insufficiency, we have correlated plasma levels of lipids and apolipoproteins at start of follow-up with the subsequent change in renal function in 34 adult patients with chronic renal disease. Nineteen patients had primary renal disease, and 15 patients had diabetic nephropathy. Except for antihypertensive therapy no specific treatment to modify the progression of the disease was given during the follow-up. The rate of progression was determined by repeated measurements of the glomerular filtration rate (GFR). The time of follow-up ranged from 12 to 91 months with an average of 39.7 +/- 16.7 months. The mean initial GFR was 34.7 +/- 13.9 ml/min x 1.73 m2 body surface area and the average decline in renal function was -0.27 +/- 0.26 ml/min/month. The entry levels of triglycerides (TG; p = 0.04), very-low-density lipoprotein cholesterol (p = 0.03), apolipoprotein-B (ApoB; p = 0.008) and systolic blood pressure (SBP; p = 0.04) were significantly correlated with the rate of progression. Among lipoprotein variables, ApoB showed the strongest correlation with the decline in GFR. Patients with a progressive course of their disease also tended to have initially higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (NS), whereas the initial plasma concentration of high-density lipoprotein cholesterol did not show an association with the progression of renal insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS)
高脂血症与实验性肾功能不全时肾小球硬化加速相关。为研究人类肾衰竭时出现的血脂蛋白异常是否也会影响肾功能不全的未来病程，我们对34例成年慢性肾病患者随访开始时的血脂和载脂蛋白水平与随后的肾功能变化进行了相关性分析。19例患者患有原发性肾病，15例患者患有糖尿病肾病。随访期间，除抗高血压治疗外，未给予其他特定治疗以改变疾病进展。通过重复测量肾小球滤过率（GFR）来确定疾病进展速率。随访时间为12至91个月，平均为39.7±16.7个月。平均初始GFR为34.7±13.9 ml/min×1.73 m2体表面积，肾功能平均下降速率为-0.27±0.26 ml/min/月。甘油三酯（TG；p = 0.04）、极低密度脂蛋白胆固醇（p = 0.03）、载脂蛋白B（ApoB；p = 0.008）和收缩压（SBP；p = 0.04）的初始水平与疾病进展速率显著相关。在脂蛋白变量中，ApoB与GFR下降的相关性最强。疾病呈进行性发展的患者最初的总胆固醇（TC）和低密度脂蛋白胆固醇水平也往往较高（无统计学意义）[1]，而高密度脂蛋白胆固醇的初始血浆浓度与肾功能不全的进展无相关性。（摘要截短至250字） [1] 此处原文“whereas the initial plasma concentration of high-density lipoprotein cholesterol did not show an association with the progression of renal insufficiency.(NS)”中“(NS)”可能有误，推测为无统计学意义之意，译文按此理解翻译。
