Lye W C, Hughes K, Leong S O, Lee E J
Department of Medicine, National University Hospital, Singapore.
Adv Perit Dial. 1995;11:131-3.
Dyslipidemia is an important risk factor for atherosclerotic vascular disease. Serum lipoprotein (a) [Lp(a)] has been implicated as an independent atherogenic risk factor. We measured serum (Lp(a) levels in our patients and studied its correlations with other lipoproteins and clinical parameters. All stable patients on continuous ambulatory peritoneal dialysis (CAPD) for more than one month were enrolled in the study. Fasting serum Lp(a), total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, apolipoprotein-A and apolipoprotein-B levels were measured on entering the CAPD program and at 3 monthly intervals. One hundred and nine patients (M/F: 65/44, mean age +/- SD: 59.5 +/- 12.0 years) were studied. Fifty-two patients had diabetes mellitus. Age- and sex-matched normals were used as controls. Serum Lp(a) levels were raised in 54.5% of CAPD patients compared to 18.6% of controls (p < 0.01). There was no significant change in Lp(a) levels over time. Serum Lp(a) levels showed positive and negative correlations with LDL-cholesterol and triglycerides, respectively, but not with age, sex, diabetic status, and serum total cholesterol and albumin levels. Thirty-six of 54 (66.7%) patients with serum Lp(a) levels greater than 30 mg/dL had either coronary, cerebral, and/or peripheral vascular disease compared to 30/55 (54.5%) of patients with serum Lp(a) levels less than 30 mg/dL (p = NS). In conclusion, serum Lp(a) levels were raised in a significant proportion of CAPD patients, but there was no significant association with vascular disease.
血脂异常是动脉粥样硬化性血管疾病的重要危险因素。血清脂蛋白(a)[Lp(a)]被认为是一个独立的致动脉粥样硬化危险因素。我们检测了患者的血清Lp(a)水平，并研究了其与其他脂蛋白及临床参数的相关性。所有接受持续非卧床腹膜透析(CAPD)超过1个月的稳定患者均纳入本研究。在进入CAPD项目时及每隔3个月测量空腹血清Lp(a)、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白A和载脂蛋白B水平。共研究了109例患者（男/女：65/44，平均年龄±标准差：59.5±12.0岁）。其中52例患者患有糖尿病。年龄和性别匹配的正常人作为对照。与18.6%的对照组相比，54.5%的CAPD患者血清Lp(a)水平升高(p<0.01)。Lp(a)水平随时间无显著变化。血清Lp(a)水平分别与低密度脂蛋白胆固醇和甘油三酯呈正相关和负相关，但与年龄、性别、糖尿病状态、血清总胆固醇和白蛋白水平无关。血清Lp(a)水平大于30mg/dL的54例患者中有36例(66.7%)患有冠状动脉、脑和/或外周血管疾病，而血清Lp(a)水平小于30mg/dL的55例患者中有30例(54.5%)患有上述疾病(p=无显著性差异)。总之，相当一部分CAPD患者血清Lp(a)水平升高，但与血管疾病无显著关联。
