Defective high-density lipoprotein composition in patients on chronic hemodialysis. A possible mechanism for accelerated atherosclerosis.
We determined serum high-density lipoprotein cholesterol content and analyzed the approtein structure of the various lipoprotein fractions in 21 patients on chronic hemodialysis. High-density lipoprotein cholesterol was significantly reduced in all patients as compared with 11 normal persons (mean +/-1 standard deviation: 26 +/- 13 vs. 52 +/- 9 mg per 100 ml; P less than 0.001) whether or not triglyceride levels were raised. In seven of those with Type IV hyperlipoproteinemia, protein content of high-density lipoprotein and its subfractions 1, 2 and 3 were also reduced (P less than 0.001) in parallel with reductions in cholesterol in these fractions. Apoprotein electrophoresis showed an increase in "arginine-rich" peptide in very-low-density lipoprotein and high-density lipoprotein fraction 1, and a reduction in apoprotein Cll in very-low-density and high-density lipoprotein. In addition to their reduced high-density lipoprotein cholesterol levels, a major factor in the atherosclerosis of these patients may be their abnormal high-density lipoprotein composition. Their raised triglyceride levels could be due to defective lipoprotein lipase activation by the reduced very-low-density lipoprotein apoprotein.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001053:Apolipoproteins / Q000097:blood; D001059:Apoproteins / Q000097:blood; D001120:Arginine / Q000097:blood; D001161:Arteriosclerosis / Q000209:etiology*; D002784:Cholesterol / Q000097:blood; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000209:etiology; D008075:Lipoproteins, HDL / Q000097:blood*; D008079:Lipoproteins, VLDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood; D010641:Phenotype; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D001053:Apolipoproteins; D001059:Apoproteins; D008075:Lipoproteins, HDL; D008079:Lipoproteins, VLDL; D010455:Peptides; D014280:Triglycerides; D001120:Arginine; D002784:Cholesterol