title: Shift of high-density lipoprotein size distribution toward large particles in patients with proteinuria.
abstract: BACKGROUND
  The potential atheroprotective role of the different HDL subclasses may depend on the metabolic factors that affect their plasma concentrations. The kidney is supposed to be one of the main catabolic sites for these lipoproteins. However, little is known about the impact of proteinuria on HDL size distribution and HDL structure. The aim of this study is to establish the influence of proteinuria on HDL size distribution and cholesterol plasma concentration of HDL subclasses.
  
  
  METHODS
  Forty patients within a range of proteinuria from 0.2 to 10.0 g/g estimated by the urinary protein-to-creatinine ratio and 40 healthy controls were enrolled in the study. HDL subclasses were separated by sequential ultracentrifugation followed by a polyacrylamide gradient electrophoresis; gels were stained enzymatically for cholesterol and with Coomasie blue for proteins. HDL size distribution and plasma concentration of the five HDL subclasses were calculated by optical densitometry.
  
  
  RESULTS
  When determined by protein, large HDL2b and HDL2a relative proportions were higher in patients than in control subjects, whereas the contrary was observed for small HDL3b and 3c. Consistently, HDL3a, 3b, and 3c were negatively correlated with proteinuria when data were adjusted by age, gender, body mass index, and blood pressure. Size distribution followed a different pattern when determined by cholesterol, suggesting an abnormal lipid composition that was further supported by a protein-to-cholesterol ratio significantly higher in most of the HDL subclasses in proteinuric patients than in the control group. Moreover, proteinuria statistically explains the HDL2b and HDL3c cholesterol plasma concentrations.
  
  
  CONCLUSIONS
  Proteinuria is associated with a shift of HDL size distribution towards large particles and cholesterol-poor HDL subclasses. These results support the idea of a selective loss by the kidney of small HDL in patients with proteinuria; whether these abnormalities reflect an impaired reverse cholesterol transport and an increased risk of coronary heart disease remains to be elucidated.
authors.affiliation: Department of Molecular Biology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico DF, Mexico.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Soto-Miranda
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Carreón-Torres
authors.forename: Karina
authors.initials: K
authors.lastname: Lorenzo
authors.forename: Berenice
authors.initials: B
authors.lastname: Bazán-Salinas
authors.forename: Cynthia
authors.initials: C
authors.lastname: García-Sánchez
authors.forename: Martha
authors.initials: M
authors.lastname: Franco
authors.forename: Carlos
authors.initials: C
authors.lastname: Posadas-Romero
authors.forename: José-Manuel
authors.initials: JM
authors.lastname: Fragoso
authors.forename: Victoria
authors.initials: V
authors.lastname: López-Olmos
authors.forename: Magdalena
authors.initials: M
authors.lastname: Madero
authors.forename: José-Manuel
authors.initials: JM
authors.lastname: Rodriguez-Pérez
authors.forename: Gilberto
authors.initials: G
authors.lastname: Vargas-Alarcón
authors.forename: Oscar
authors.initials: O
authors.lastname: Pérez-Méndez
mesh_terms: D000293:Adolescent; D000328:Adult; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood / Q000652:urine; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood* / Q000737:chemistry / Q000302:isolation & purification; D008875:Middle Aged; D010316:Particle Size; D011507:Proteinuria / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000097:blood*; D012984:Software; D055815:Young Adult
chemical_list: D008075:Lipoproteins, HDL; D002784:Cholesterol; D003404:Creatinine