Kostner K M, Clodi M, Bodlaj G, Watschinger B, Hörl W, Derfler K, Huber K
Second Department of Medicine, University of Vienna, Austria.
Eur J Clin Invest. 1998 Jun;28(6):447-52. doi: 10.1046/j.1365-2362.1998.00319.x.
Plasma lipoprotein (a) [Lp(a)] levels are elevated in patients with kidney disease and are strongly associated with premature cardiovascular disease and stroke.
As the kidney is suggested to play an important role in apolipoprotein (a) [apo(a)] catabolism and as apo(a) fragments appear in urine, we determined plasma Lp(a) levels and urinary apo(a) excretion in relation to kidney function in a large cohort of renal patients. A total of 368 renal patients with normal or different degrees of impaired renal function and 163 healthy control subjects matched for age and sex were investigated. Plasma Lp(a) and urinary apo(a) were analysed immunochemically.
Renal patients were found to have significantly elevated total cholesterol and low-density lipoprotein (LDL)-C values but lower high-density lipoprotein (HDL)-C values than control subjects. Plasma Lp(a) values were significantly higher only in patients with creatinine clearance < 70 mL min-1. There was a significant correlation between urinary apo(a) and plasma Lp(a) in patients and control subjects. Urinary apo(a) excretion was significantly lower in patients than in control subjects and showed no correlation with urinary protein excretion.
Although it is unlikely that impaired renal excretion of apo(a) fragments largely contributes to increased plasma Lp(a) levels in patients suffering from impaired kidney function, these data suggest that urinary apo(a) excretion is significantly decreased in renal patients and that this might contribute to increased plasma Lp(a) levels in this patient group.
肾病患者的血浆脂蛋白(a)[Lp(a)]水平升高，且与早发性心血管疾病和中风密切相关。
由于肾脏在载脂蛋白(a)[apo(a)]分解代谢中被认为起重要作用，且apo(a)片段出现在尿液中，我们在一大群肾病患者中测定了与肾功能相关的血浆Lp(a)水平和尿apo(a)排泄量。共调查了368例肾功能正常或不同程度受损的肾病患者以及163例年龄和性别匹配的健康对照者。采用免疫化学方法分析血浆Lp(a)和尿apo(a)。
发现肾病患者的总胆固醇和低密度脂蛋白(LDL)-C值显著升高，但高密度脂蛋白(HDL)-C值低于对照者。仅肌酐清除率<70 ml·min-1的患者血浆Lp(a)值显著更高。患者和对照者的尿apo(a)与血浆Lp(a)之间存在显著相关性。患者的尿apo(a)排泄量显著低于对照者，且与尿蛋白排泄量无相关性。
尽管apo(a)片段的肾脏排泄受损不太可能在很大程度上导致肾功能受损患者血浆Lp(a)水平升高，但这些数据表明肾病患者的尿apo(a)排泄量显著降低，这可能导致该患者群体的血浆Lp(a)水平升高。
