Lipoprotein abnormalities without hyperlipidaemia in moderate renal insufficiency.
To characterize lipoprotein metabolism during early renal insufficiency, plasma lipid and apolipoprotein profiles were determined in normotriglyceridaemic (NTG, n = 31) and hypertriglyceridaemic (HTG, n = 30) middle-aged patients with primary renal disease and with moderately impaired renal function (GFR 20-55 ml/min, mean: 37.2). Mean GFR was similar in the two patient groups. They were compared with 102 normolipidaemic control subjects. In comparison with controls the NTG patients (plasma triglycerides TG < or = 1.7 mmol/l, mean TG: 1.16 mmol/l) had significantly increased plasma concentrations of apo C-III and apoB. The apoA-I levels tended to be lower and as a consequence the apoA-I/apoC-III ratio, considered to represent the hallmark of the altered apolipoprotein profile in renal dyslipoproteinaemia, was markedly lower in NTG patients (8.7 versus 16.8, P < 0.001). There was also a reduction of the antiatherogenic ratio apoA-I/apoB and an increase of the apoC-III/apoE ratio. The HTG patients (mean TG: 3.22 mmol/l) showed the same, but even more accentuated, qualitative changes as the NTG patients. There was a fourfold increase of apoC-III in VLDL-LDL lipoprotein fractions with little change in HDL in the HTG patients. In NTG patients the increase of apoC-III was found in VLDL-LDL and in HDL. Plasma insulin and PTH levels both correlated with the apoA-I/apoC-III ratio independently of GFR and BMI. This suggests a pathogenetic relationship between PTH-mediated alterations of insulin metabolism and the lipoprotein abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)
Samuelsson
O
O
Department of Nephrology, University of Göteborg, Sweden.
Attman
P O
PO
Knight-Gibson
C
C
Kron
B
B
Larsson
R
R
Mulec
H
H
Weiss
L
L
Alaupovic
P
P
D001053:Apolipoproteins / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood; D007328:Insulin / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000209:etiology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D014280:Triglycerides / Q000097:blood
D001053:Apolipoproteins; D007328:Insulin; D008055:Lipids; D010281:Parathyroid Hormone; D014280:Triglycerides