Fernández-Miranda C, de la Calle A, Morales J M, Guijarro C, Aranda J L, Gómez-Sanz R, Gómez-Izquierdo T, Larumbe S, Moreno E, Rodicio J L, del Palacio A
Service Internal Medicine, Hospital Universitario, 12 de Octubre, Madrid, Spain.
Clin Transplant. 1998 Apr;12(2):136-41.
Hyperlipidemia is a common feature after organ transplantation. Most studies have evaluated the lipid profile in recipients of a particular graft, usually renal. In the present work, we studied the lipid profiles of 30 long-term stable liver transplant patients (LTP) and compared their pattern with 40 long-term stable renal transplant patients (RTP) matched for gender, age, and time from transplantation. There were no significant differences between both groups in body mass index, serum glucose, serum creatinine, or urinary protein excretion. In contrast, RTP had higher pre-transplant total cholesterol and triglycerides, received higher doses of steroids (both average and cumulative) and had higher cycosplorine blood levels. After a mean time of 60 months after transplantation, RTP exhibited higher levels of total serum cholesterol (226 +/- 26 vs. 180 +/- 39 mg/dl; p = 0.000 002) and low-density lipoprotein (LDL) cholesterol (152 +/- 22 vs. 112 +/- 37 mg/dl; p = 0.00001). In contrast, there were no differences between RTP and LTP in high density lipoprotein (HDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, total triglycerides, VLDL triglycerides, or lipoprotein (a) [Lp(a)]. By univariate analysis in the whole group, renal graft, prednisone daily dose, cyclosporine blood levels, pre-transplant cholesterol, and triglycerides were associated with increased post-transplant cholesterol levels. By multivariate analysis, prednisone daily dose was the only independent variable predicting increased post-transplant serum cholesterol levels. The present data show that hypercholesterolemia is more frequent among RTP than among LTP. In addition, our data suggest that corticosteroid therapy, rather than the transplanted organ, may be the major contributor to this difference.
高脂血症是器官移植后的常见特征。大多数研究评估了特定移植物（通常是肾移植）受者的血脂情况。在本研究中，我们对30例长期稳定的肝移植患者（LTP）的血脂情况进行了研究，并将其模式与40例在性别、年龄和移植时间上相匹配的长期稳定的肾移植患者（RTP）进行了比较。两组在体重指数、血清葡萄糖、血清肌酐或尿蛋白排泄方面无显著差异。相比之下，RTP移植前的总胆固醇和甘油三酯水平较高，接受的类固醇剂量（平均剂量和累积剂量）较高，环孢素血药浓度也较高。移植后平均60个月时，RTP的血清总胆固醇水平（226±26 vs. 180±39 mg/dl；p = 0.000002）和低密度脂蛋白（LDL）胆固醇水平（152±22 vs. 112±37 mg/dl；p = 0.00001）更高。相比之下，RTP和LTP在高密度脂蛋白（HDL）胆固醇、极低密度脂蛋白（VLDL）胆固醇、总甘油三酯、VLDL甘油三酯或脂蛋白（a）[Lp（a）]方面无差异。在整个研究组中进行单因素分析，肾移植、泼尼松每日剂量、环孢素血药浓度、移植前胆固醇和甘油三酯与移植后胆固醇水平升高相关。通过多因素分析，泼尼松每日剂量是预测移植后血清胆固醇水平升高的唯一独立变量。目前的数据表明，肾移植患者中高胆固醇血症比肝移植患者更常见。此外，我们的数据表明，导致这种差异的主要因素可能是皮质类固醇治疗，而非移植器官。
