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糖尿病肾病分期与血清脂蛋白（a）浓度的关系——低蛋白血症的影响

[Relationship between the stage of diabetic nephropathy and serum lipoprotein (a) concentrations--influence of hypoproteinemia].

作者信息

Nakagawa H, Kida Y, Sakamoto K, Haneda M, Kikkawa R

机构信息

Department of Diabetes, Daini-Okamoto General Hospital, Kyoto, Japan.

出版信息

Nihon Jinzo Gakkai Shi. 1996 Nov;38(11):513-8.

PMID:8958706
Abstract

UNLABELLED

Lipoprotein (a) [Lp(a)] has been reported to be an independent risk factor for coronary heart disease. Elevated levels of Lp(a) in diabetic subjects have also been reported, especially in subjects with nephropathy. However, the mechanism and the clinical implication of Lp(a) elevation in diabetics remain obscure. In the present study, to verify the change in Lp(a) concentration with the progression of nephropathy, serum Lp(a) levels were measured in 546 NIDDM patients, 33 hemodialysis NIDDM patients, and 145 non-diabetic controls.

RESULTS

  1. The serum Lp(a) levels in diabetics were significantly higher than those in the non-diabetic controls. 2) Serum Lp(a) concentrations in microalbuminuric subjects were significantly higher than those in normoalbuminuric subjects, and were further increased in macroalbuminuric subjects. 3) In macroalbuminuric subjects, serum Lp(a) concentrations were inversely correlated with serum protein concentrations, but not with serum creatinine. 4) Once hemodialysis was started, the decrement of both serum Lp (a) and LDL-C concentrations were associated with the increment of serum protein concentrations. These data indicate that elevation of serum Lp (a) concentration in overt nephropathy could be, at least in part, due to hypoproteinemia.
摘要

未标注

据报道，脂蛋白(a)[Lp(a)]是冠心病的独立危险因素。糖尿病患者中Lp(a)水平升高也有报道，尤其是在肾病患者中。然而，糖尿病患者Lp(a)升高的机制及临床意义仍不明确。在本研究中，为验证随着肾病进展Lp(a)浓度的变化，对546例非胰岛素依赖型糖尿病（NIDDM）患者、33例接受血液透析的NIDDM患者和145例非糖尿病对照者测定了血清Lp(a)水平。

结果

1）糖尿病患者的血清Lp(a)水平显著高于非糖尿病对照者。2）微量白蛋白尿患者的血清Lp(a)浓度显著高于正常白蛋白尿患者，且在大量白蛋白尿患者中进一步升高。3）在大量白蛋白尿患者中，血清Lp(a)浓度与血清蛋白浓度呈负相关，但与血清肌酐无关。4）一旦开始血液透析，血清Lp(a)和低密度脂蛋白胆固醇（LDL-C）浓度的降低与血清蛋白浓度的升高相关。这些数据表明，显性肾病患者血清Lp(a)浓度升高至少部分归因于低蛋白血症。

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