Antiproteinuric therapy decreases LDL-cholesterol as well as HDL-cholesterol in non-diabetic proteinuric patients: relationships with cholesteryl ester transfer protein mass and adiponectin.
OBJECTIVE
Dyslipidemia contributes to increased cardiovascular risk in nephrotic syndrome. We questioned whether reduction in proteinuria not only lowers low-density lipoprotein cholesterol (LDL-C), but also high-density lipoprotein cholesterol (HDL-C) and cholesteryl ester transfer protein (CETP) mass and whether changes in HDL-C were related to changes in plasma adiponectin.


METHODS
Thirty-two non-diabetic proteinuric patients (12 on statin therapy), were followed during two double blind 6-week periods of placebo and treatment (low sodium + 100mg losartan + 25 mg hydrochlorothiazide).


RESULTS
With placebo HDL-C was lower but LDL-C and CETP were not different in proteinuric patients compared with matched controls. LDL-C, HDL-C and CETP decreased upon proteinuria reduction. The decrease in LDL-C correlated with the drop in CETP and the degree of proteinuria reduction. HDL-C also decreased in proportion to proteinuria lowering. Individual changes in HDL-C were correlated with changes in adiponectin.


CONCLUSIONS
LDL-C lowering upon robust reduction of proteinuria may be affected by changes in plasma CETP mass, but this treatment also decreases HDL-C in relation to the degree of proteinuria reduction. This adverse effect on HDL-C may in part be attributable to changes in adiponectin.
Krikken
J A
JA
University Medical Center Groningen, Division of Nephrology, Hanzeplein 1, Department of Internal Medicine, 9713 GZ Groningen, The Netherlands. j.a.krikken@int.umcg.nl
Waanders
F
F
Dallinga-Thie
G M
GM
Dikkeschei
L D
LD
Vogt
L
L
Navis
G J
GJ
Dullaart
R P F
RP
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D053480:Cholesterol Ester Transfer Proteins / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control; D004039:Diet, Sodium-Restricted; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000494:pharmacology / Q000627:therapeutic use*; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism; D019808:Losartan / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy*; D012306:Risk; D055815:Young Adult
D052242:Adiponectin; D047228:Angiotensin II Type 1 Receptor Blockers; C506642:CETP protein, human; D053480:Cholesterol Ester Transfer Proteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006852:Hydrochlorothiazide; D019808:Losartan