Teruel J L, Lasuncion M A, Rivera M, Aguilera A, Ortega H, Tato A, Marcen R, Ortuño J
Servicio de Nefrología, Hospital Ramón y Cajal, Madrid, Spain.
Am J Kidney Dis. 1997 Apr;29(4):569-75. doi: 10.1016/s0272-6386(97)90340-1.
We have studied the changes in the lipid profile of 14 chronic hemodialysis patients receiving a 6-month cycle of nandrolone decanoate as treatment for anemia. Nandrolone decanoate was administered in a weekly intramuscular dose of 200 mg and resulted in an increase in the hemoglobin concentration (baseline, 7.9 +/- 0.9 g/dL; month 6, 10.8 +/- 1.7 g/dL; P < 0.001, ANOVA) and also produced relevant modifications in the lipid concentrations. The most significant finding was a decrease in the concentration of lipoprotein(a) [Lp(a)]: baseline, 19.8 mg/dL (median), month 2, 10.6 mg/dL; month 4, 8.7 mg/dL; and month 6, 7.1 mg/dL (P < 0.001, Friedman). Other lipid changes induced by nandrolone decanoate were an increase in the concentrations of apolipoprotein B (P < 0.02, ANOVA) and triglyceride (P = NS, ANOVA) and a decrease of high-density lipoprotein (HDL) cholesterol (P < 0.001, ANOVA) and apolipoprotein A-I (P = NS, ANOVA). The decrease in HDL cholesterol was at the expense of the HDL2 cholesterol subfraction, whereas HDL3 remained unchanged. These lipid modifications were reversible; 4 months after nandrolone decanoate withdrawal, the lipid concentrations were similar to the basal values. The changes in Lp(a) levels did not correlate with those of hemoglobin or the other lipid parameters, suggesting that the underlying mechanisms are unrelated. Our findings could be clinically relevant if confirmed by further studies.
我们研究了14例接受癸酸诺龙6个月疗程治疗贫血的慢性血液透析患者的血脂变化情况。癸酸诺龙每周肌肉注射剂量为200mg，结果血红蛋白浓度升高（基线值为7.9±0.9g/dL；第6个月时为10.8±1.7g/dL；P<0.001，方差分析），同时血脂浓度也发生了相关改变。最显著的发现是脂蛋白(a)[Lp(a)]浓度降低：基线值为19.8mg/dL（中位数），第2个月时为10.6mg/dL；第4个月时为8.7mg/dL；第6个月时为7.1mg/dL（P<0.001，弗里德曼检验）。癸酸诺龙引起的其他血脂变化包括载脂蛋白B浓度升高（P<0.02，方差分析）和甘油三酯升高（P=无统计学意义，方差分析），以及高密度脂蛋白（HDL）胆固醇降低（P<0.001，方差分析）和载脂蛋白A-I降低（P=无统计学意义，方差分析）。HDL胆固醇的降低是以HDL2胆固醇亚组分减少为代价的，而HDL3保持不变。这些血脂改变是可逆的；停用癸酸诺龙4个月后，血脂浓度与基线值相似。Lp(a)水平的变化与血红蛋白或其他血脂参数的变化无关，提示其潜在机制不同。如果进一步研究证实，我们的发现可能具有临床意义。
