RESUMEN
OBJECTIVE: To explore the distribution pattern for serum lipid concentrations among patients with different degrees of chronic renal failure; to study the characteristics of abnormal lipid metabolism for chronic renal failure patients when the disease progress further. SETTING: No. 255 Hospital of PLA, Tangshan, Hebei, China; No. 281 Hospital of PLA, Beidanhe, Hebei, China; and the General Hospital of Beijing Military Region, Beijing, China. PRACTICE DESCRIPTION: A total of 240 serum/urine samples from 50 healthy volunteers and from 190 patients with different degrees of chronic renal failure, which fall into four groups according to their glomerular filtration rates, were measured for serum levels of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and for urine albumin concentrations; the levels of these criteria were compared between the control group and diseased groups; the mean concentrations of different lipid variables were paired and subjected to linear regression analysis. MAIN OUTCOME MEASUREMENTS: Glomerular filtration rates were estimated by the iohexol clearance method, in which plasma content of iohexol was measured with high performance liquid chromatography; concentrations of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and albumin were assayed according to standard protocols. RESULTS: Serum levels of triglyceride, lipoprotein(a), lipoprotein(a) cholesterol, total cholesterol, apolipoprotein A1, apolipoprotein B100, low density lipoprotein cholesterol, and urine albumin contents were significantly higher, whereas those of high density lipoprotein cholesterol were lower, in diseased groups than that of the control (p < 0.05, p < 0.01). When the disease progressed, concentrations of these criteria increased or decreased further (p < 0.01, p < 0.05). Significant correlations were found between a few lipid criteria for their mean concentrations in diseased groups. CONCLUSION: The study demonstrates a correlation between abnormalities of lipid metabolism and the degrees of kidney insufficiency, and a correlation within certain kinds of lipid criteria in patients with different degrees of renal damage. The results suggest the existence of multi-correlations in vivo in catabolism and metabolism of lipid, lipoprotein, apolipoprotein, and protein in the patients. The exact mechanism responsible for the association and correlation remains to be clarified.
Asunto(s)
Fallo Renal Crónico/sangre , Lípidos/sangre , Adulto , Análisis de Varianza , Biomarcadores , Estudios de Casos y Controles , Progresión de la Enfermedad , Femenino , Humanos , Fallo Renal Crónico/orina , Modelos Lineales , Lípidos/orina , MasculinoRESUMEN
OBJECTIVE: To estimate the stability and reliability of lipoprotein(a) cholesterol measurement, and explore the possibility to evaluate lipoprotein(a) excess in plasma by using lipoprotein(a)-cholesterol assay alternatively to assay lipoprotein(a). SETTING: Number 255 Hospital of PLA, Tangshan, Hebei, China. PRACTICE DESCRIPTION: A total of 396 plasma samples from 100 healthy people (control), 107 chronic renal failure patients, 114 coronary heart disease patients, and 75 cerebral infarction patients, respectively, were measured for lipoprotein(a) cholesterol and lipoprotein(a) mass; lipoprotein(a) cholesterol and lipoprotein(a) mass levels among control and diseased groups were compared; and lipoprotein(a) cholesterol levels and lipoprotein(a) mass values from the control group were subjected to linear regression analysis. MAIN OUTCOME MEASUREMENTS: The affinity between oligosaccharide contained in lipoprotein(a) and lectin wheat germ agglutinin to isolate lipoprotein(a) from other lipoproteins; lipoprotein(a) cholesterol and lipoprotein(a) mass detected by total cholesterol kits and enzyme linked immunosorbent assay kits, respectively. RESULTS: Both lipoprotein(a) cholesterol and lipoprotein(a) mass levels of the chronic renal failure, coronary heart disease, and cerebral infarction groups were significantly higher than those of the control (P < 0.05 or P < 0.01) whereas no difference was seen among the diseased groups at the 0.05 level. Regression analysis within the control group showed a very high correlation between lipoprotein(a) cholesterol and lipoprotein(a) (r = 0.9932). CONCLUSION: The results suggest that lipoprotein(a) cholesterol assay may be used in the place of lipoprotein(a) measurement for evaluating lipoprotein(a) excess for chronic renal failure, coronary heart disease, and cerebral infarction patients. Further studies about the mechanism of this association between lipoprotein(a) cholesterol and lipoprotein(a) levels are needed.