De Lima J J, Latrilha M da C, Toffoletto O, Ianhez L E, Krieger E M, Maranhão R C
Hypertension Unit, Hospital das Clínicas, São Paulo University Medical School, Brazil.
Clin Cardiol. 1998 Jun;21(6):411-3. doi: 10.1002/clc.4960210608.
Atherosclerotic cardiovascular disease is prevalent among renal transplant patients. Increase in serum total cholesterol, low-density lipoprotein, and very low-density lipoprotein is common in those patients. Alterations in chylomicron metabolism, however, are also related to atherogenesis and were not studied in renal transplant.
The aim of this study was to evaluate chylomicron metabolism in renal transplant recipients receiving cyclosporin-based immunosuppression. We determined the plasma kinetics of triglyceride-rich emulsions labeled with [3H]triolein and [14C]cholesteryl oleate that are known to mimic the chylomicron metabolism when injected into the blood stream.
Fourteen renal transplant recipients with normal renal function (10 men, 4 women, aged 40 +/- 6.1 years) and 17 age- and gender-matched healthy controls received bolus injections of the chylomicron-like emulsion. Plasma samples were then taken at regular intervals during 60 min. Disappearance curves of the labels and the respective fractional clearance rates (FCR) were calculated in order to measure lipolysis and chylomicron remnant removal from the plasma.
Fasting serum lipid levels did not differ in the two groups. The difference between Median FCR of [3H]triolein emulsion in renal transplant patients and that obtained in the controls (0.07 vs. 0.11 min-1, NS) was not statistically significant. Median FCR of [14C]cholesteryl oleate also did not differ between the groups (patients: 0.044; controls: 0.046, NS).
These results indicate that neither chylomicron lipolysis nor remnant removal are affected in stable renal transplant patients treated with cyclosporin-based immunosuppression.
动脉粥样硬化性心血管疾病在肾移植患者中很常见。这些患者血清总胆固醇、低密度脂蛋白和极低密度脂蛋白升高很常见。然而,乳糜微粒代谢的改变也与动脉粥样硬化的发生有关,且在肾移植中尚未进行研究。
本研究的目的是评估接受以环孢素为基础的免疫抑制治疗的肾移植受者的乳糜微粒代谢。我们测定了用[3H]三油酸甘油酯和[14C]胆固醇油酸酯标记的富含甘油三酯乳剂的血浆动力学,已知当注入血流时这些乳剂可模拟乳糜微粒代谢。
14例肾功能正常的肾移植受者(10例男性,4例女性,年龄40±6.1岁)和17例年龄及性别匹配的健康对照者接受了类似乳糜微粒乳剂的大剂量注射。然后在60分钟内定期采集血浆样本。计算标记物的消失曲线和各自的分数清除率(FCR),以测量血浆中的脂解作用和乳糜微粒残粒清除情况。
两组的空腹血脂水平无差异。肾移植患者中[3H]三油酸甘油酯乳剂的中位FCR与对照组的中位FCR(0.07对0.11分钟-1,无统计学意义)之间的差异无统计学意义。两组之间[14C]胆固醇油酸酯的中位FCR也无差异(患者:0.044;对照组:0.046,无统计学意义)。
这些结果表明,接受以环孢素为基础的免疫抑制治疗的稳定肾移植患者的乳糜微粒脂解作用和残粒清除均未受影响。