Serum homocysteine levels in renal transplant recipients with and without hypercholesterolemia.
BACKGROUND
Hyperhomocysteinemia seems to be frequent after renal transplantation. No study so far has assessed the role of homocysteine (Hcy) associated with dyslipidemia in Brazil.


OBJECTIVE
To determine the prevalence of hyperhomocysteinemia (serum Hcy >15 mmol/l) in stable renal transplant recipients and to evaluate the role of serum lipids and graft function in serum Hcy levels.


METHODS
One hundred and five stable renal transplant recipients were evaluated, considering age, post-transplant time, cholesterol levels, graft function, proteinuria, and cyclosporine (analyzed using multiple linear regression). The prevalence of hyperhomocysteinemia was 74.3%. Patients were further divided into two groups, hyper (total cholesterol >200 mg/dl, LDL-cholesterol >130 mg/dl) and normocholesterolemic.


RESULTS
Hypercholesterolemic recipients were older, had shorter post-transplant time, lower endogenous creatinine clearance, and higher proteinuria and Hcy serum levels. Patients with hyperhomocysteinemia had statistically significantly higher serum triglycerides and poorer graft function, and their LDL-cholesterol also tended to be higher. A positive correlation was found between serum creatinine and Hcy levels (r = 0.32, P = 0.01). Multiple regression analysis revealed that both dyslipidemia and renal function independently affect Hcy values.


CONCLUSIONS
We observed a high prevalence of hyperhomocysteinemia in renal transplant recipients, especially in hypercholesterolemic, suggesting that worse graft function may influence serum Hcy and cholesterol levels negatively. Further studies should investigate if this adverse metabolic profile is associated with higher cardiovascular mortality in the long term.
Piovesan
Fabiana
F
Universidade Federal do Rio Grande do Sul.
Veronese
Francisco José Veríssimo
FJ
Santos
Auri Ferreira
AF
Pozza
Roberta
R
Sarturi
Péricles Serafim
PS
Tognon
Alexandre
A
Garcia
Valter Duro
VD
Keitel
Elizete
E
Saitovitch
David
D
D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use; D050171:Dyslipidemias / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006710:Homocysteine / Q000097:blood* / Q000187:drug effects; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood*; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000097:blood; D012016:Reference Values; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D007166:Immunosuppressive Agents; D014280:Triglycerides; D006710:Homocysteine; D016572:Cyclosporine; D002784:Cholesterol; D003404:Creatinine