title: Relation of cyclosporine blood levels to adverse effects on lipoproteins.
abstract: Hyperlipidemia is common in renal allograft recipients. To elucidate the role of cyclosporine in posttransplant hyperlipidemia, we measured lipids, lipoprotein lipids, and apolipoproteins of thirty-five renal allograft recipients and evaluated their relation to trough cyclosporine blood levels. All patients were on a triple immunosuppressive regimen with equal doses of prednisone and azathioprine, and had stable graft function. Cyclosporine blood levels were significantly correlated to total plasma cholesterol (P = 0.028), low-density lipoprotein cholesterol (P = 0.022), apolipoprotein B (P = 0.017), and the cholesterol/high-density lipoprotein cholesterol ratio (P < 0.002), but not to plasma triglycerides. Significant inverse correlations were found between cyclosporine blood levels and high-density lipoprotein cholesterol (P = 0.034), high-density lipoprotein3 cholesterol (P = 0.025), and apolipoprotein A-1 (P = 0.047), but not high-density lipoprotein2 cholesterol. The independent relation of cyclosporine blood levels to each of the measured lipid parameters was investigated by a stepwise regression model including age, body mass index, interval from transplantation, diabetes mellitus, plasma creatinine, and intake of diuretics and beta-blockers. After correction for these 7 variables, cyclosporine blood levels remained significantly associated with high-density lipoprotein cholesterol, high-density lipoprotein3 cholesterol, apolipoprotein A-1, apolipoprotein B, low-density lipoprotein cholesterol, and the cholesterol/high-density lipoprotein cholesterol ratio. These data suggest that cyclosporine causes atherogenic dyslipidemia.
authors.affiliation: Division of Cardiology, University Hospital, Zurich, Switzerland.
authors.forename: G M
authors.initials: GM
authors.lastname: Kuster
authors.forename: H
authors.initials: H
authors.lastname: Drexel
authors.forename: J A
authors.initials: JA
authors.lastname: Bleisch
authors.forename: K
authors.initials: K
authors.lastname: Rentsch
authors.forename: P
authors.initials: P
authors.lastname: Pei
authors.forename: U
authors.initials: U
authors.lastname: Binswanger
authors.forename: F W
authors.initials: FW
authors.lastname: Amann
mesh_terms: D000328:Adult; D001053:Apolipoproteins / Q000378:metabolism; D016572:Cyclosporine / Q000097:blood*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications*; D016030:Kidney Transplantation; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D001053:Apolipoproteins; D008055:Lipids; D008074:Lipoproteins; D016572:Cyclosporine