Kostner K M, Oberbauer R, Hoffmann U, Stefenelli T, Maurer G, Watschinger B
Second Department of Medicine, University of Vienna, Austria.
Nephrol Dial Transplant. 1997 Dec;12(12):2673-8. doi: 10.1093/ndt/12.12.2673.
Increased plasma Lipoprotein (a) (Lp(a)) levels are strongly associated with premature cardiovascular disease and stroke. The kidney is purported to play an important role in apo(a) catabolism. Therefore we investigated plasma Lp(a) levels in relation to kidney function and urinary apo(a) excretion.
One hundred and sixteen kidney transplant patients with normal or impaired renal function and 109 age- and sex-matched healthy controls were investigated. Plasma Lp(a) and urinary apo(a) levels were determined immunochemically and all other parameters were determined by routine laboratory methods.
Transplant recipients were found to have significantly elevated total cholesterol and LDL-C values, but equal HDL-C values compared to controls. Plasma Lp(a) values were higher and urinary apo(a) excretion was lower in transplant recipients compared to controls, independent of renal function. When the patient group was subdivided into 'normal' and 'impaired creatinine clearance', only the latter group secreted less apo(a) than normal controls.
These data suggest that urinary apo(a) excretion is reduced in transplant recipients with impaired excretory graft function, which may contribute to the elevation of plasma Lp(a) levels in these patients.
血浆脂蛋白(a)[Lp(a)]水平升高与早发性心血管疾病和中风密切相关。肾脏被认为在载脂蛋白(a)[apo(a)]的分解代谢中起重要作用。因此，我们研究了血浆Lp(a)水平与肾功能及尿apo(a)排泄之间的关系。
对116例肾功能正常或受损的肾移植患者及109例年龄和性别匹配的健康对照者进行了研究。采用免疫化学方法测定血浆Lp(a)和尿apo(a)水平，其他所有参数均通过常规实验室方法测定。
与对照组相比，肾移植受者的总胆固醇和低密度脂蛋白胆固醇(LDL-C)值显著升高，但高密度脂蛋白胆固醇(HDL-C)值相当。与对照组相比，肾移植受者的血浆Lp(a)值更高，尿apo(a)排泄更低，且与肾功能无关。当将患者组分为“肌酐清除率正常”和“肌酐清除率受损”两组时，只有后一组的apo(a)分泌量低于正常对照组。
这些数据表明，排泄性移植肾功能受损的肾移植受者尿apo(a)排泄减少，这可能导致这些患者血浆Lp(a)水平升高。
