Genetic factors play an important role in the pathogenesis of hyperlipidemia post-transplantation.
BACKGROUND
Our purpose was to identify factors associated with hyperlipidemia post-transplantation in a Hispanic population.


METHODS
From 1985 to 1999, a kidney graft survival longer than 3 months occurred in 293 cases at the Instituto Nacional de la Nutrición. Most of the patients living in Mexico City were included (n = 83). The evaluation included a questionnaire, blood samples, and assessment of body composition and dietary habits. As many as possible first-degree relatives were studied.


RESULTS
Women had higher values of cholesterol (236 +/- 51 versus 215 +/-41; P < 0.05), low-density lipoprotein cholesterol (147 +/- 42 versus 131 +/- 34; P = 0.05), high-density lipoprotein cholesterol (57.3 +/- 14 versus 47.9 +/- 14; P = 0.002) and high-density lipoprotein-2 cholesterol. Isolated hypercholesterolemia was the most common lipid abnormality (40.9%), followed by mixed hyperlipidemia. Lipoprotein (a) greater than 30 mg/dL was found in 13 cases. Familial combined hyperlipidemia (FCHL) in the patient's relatives was a marker for dyslipidemia (odds ratio, 7.04; 95% confidence interval, 1.2 to 59.7). These cases had a worse lipid profile. Cyclosporine-treated FCHL patients had higher lipid levels compared with the non-FCHL, cyclosporine-treated patients. The effects of cyclosporine on the lipid levels were lower, but significant, after the exclusion of the FCHL cases.


CONCLUSIONS
Post-transplant dyslipidemia is determined by genetic and environmental factors. FCHL in the patient's relatives was associated with post-transplant hyperlipidemia; an additive effect with cyclosporine was found. The evaluation of the lipid profile of relatives may be useful for the assessment of the risk of post-transplant dyslipidemia.
Aguilar-Salinas
Carlos A
CA
Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. caguilarsalinas@yahoo.com
Díaz-Polanco
Araceli
A
Quintana
Eduardo
E
Macias
Nayeli
N
Arellano
Adriana
A
Ramírez
Erika
E
Ordóñez
María Luisa
ML
Velásquez-Alva
Consuelo
C
Gómez Pérez
Francisco J
FJ
Alberú
Josefina
J
Correa-Rotter
Ricardo
R
D000328:Adult; D001057:Apolipoproteins E / Q000235:genetics; D001823:Body Composition / Q000235:genetics; D002784:Cholesterol / Q000097:blood / Q000235:genetics / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood / Q000235:genetics / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood / Q000235:genetics / Q000378:metabolism; D000075202:Contraindications; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D004032:Diet / Q000009:adverse effects; D005260:Female; D020022:Genetic Predisposition to Disease; D006085:Graft Survival / Q000235:genetics; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000235:genetics; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008800:Mexico; D012737:Sex Factors; D011795:Surveys and Questionnaires
D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D002784:Cholesterol