促肾上腺皮质激素可降低接受类固醇治疗的肾病高脂血症患者的血脂。

ACTH lowers serum lipids in steroid-treated hyperlipemic patients with kidney disease.

作者信息

Berg A L, Nilsson-Ehle P

机构信息

Department of Nephrology, University Hospital, Lund, Sweden.

出版信息

Kidney Int. 1996 Aug;50(2):538-42. doi: 10.1038/ki.1996.346.

DOI:10.1038/ki.1996.346

PMID:8840283

Abstract

The mechanisms behind secondary hyperlipidemia in patients with various chronic inflammatory diseases are not known in detail. We have recently demonstrated that ACTH exerts strong hypolipidemic effects in healthy volunteers. To test the clinical relevance of this finding, we administrated ACTH during three weeks to nine hyperlipidemic steroid-treated patients with kidney disease. Before administration of ACTH 1-24, plasma ACTH concentrations were low. Treatment with ACTH led to 20 to 50% reductions in serum concentrations of triglycerides, cholesterol, LDL cholesterol and Apo B as well as of Lp(a). HDL cholesterol and Apo A1 concentrations increased by 10 to 25%. HL activity in postheparin plasma decreased by about 40% and LPL activity, which was initially low, increased by about 140%. The effects of ACTH were similar in kidney transplant recipients and in patients with inflammatory kidney disease. Our results indicate that hyperlipidemia in steroid treated patients with kidney disease may at least partly be due to iatrogenic ACTH deficiency.

摘要

各种慢性炎症性疾病患者继发性高脂血症背后的机制尚不清楚。我们最近证明，促肾上腺皮质激素（ACTH）在健康志愿者中具有强大的降血脂作用。为了测试这一发现的临床相关性，我们对9名接受类固醇治疗的高脂血症肾病患者进行了为期三周的ACTH给药。在给予促肾上腺皮质激素1-24之前，血浆促肾上腺皮质激素浓度较低。促肾上腺皮质激素治疗导致甘油三酯、胆固醇、低密度脂蛋白胆固醇和载脂蛋白B以及脂蛋白（a）的血清浓度降低20%至50%。高密度脂蛋白胆固醇和载脂蛋白A1浓度增加了10%至25%。肝素后血浆中的肝脂酶（HL）活性降低了约40%，而最初较低的脂蛋白脂肪酶（LPL）活性增加了约140%。促肾上腺皮质激素在肾移植受者和炎症性肾病患者中的作用相似。我们的结果表明，接受类固醇治疗的肾病患者的高脂血症可能至少部分归因于医源性促肾上腺皮质激素缺乏。