title: [Influence of elevated homocystein level and selected lipid parameters in kidney transplant patients on the progression of atherosclerotic changes assessed by intima-media thickness index (CCA-IMT)].
abstract: The aim of the study was to evaluate the influence of elevated homocystein (Hcy) level and selected lipid parameters on the progression of atherosclerotic changes in patients after kidney transplantation (KTx).
  
  
  METHODS
  The study included 51 pts (17 F, 34 M) aged 15-62 years (median 38.1) after cadaver KTx. The mean observation period equaled 21.2 months (6-24 months); while total observation period was 90 patients/ years. Hcy levels was measured using HPLC, Lp(a) and Apo-B levels using the nephelometric method and total cholesterol with its' HDL and LDL fractions, triglycerides and creatinine based on the Hitachi 917 analyzer. Patients' blood was drawn before renal transplantation and 3, 6, 9, 12, 15, 18, 21 and 24 months after KTx. Common carotid artery intima media thickness (CCA-IMT) was evaluated by ultrasound on 14 days, 12 and 24 months after KTx.
  
  
  RESULTS
  CCA-IMT correlated significantly with Hcy levels after 12 months (R=0.53; p=0.0009) and 24 months (R=0.38; p=0.0356) after KTx. Significant differences were found 12 and 24 months after KTx in CCA-IMT between patients with normal (<15 micromol/l) and increased (>15 micromol/ l) mean Hcy concentrations: p=0.0035 and p= 0.015, respectively. Analyzing changes in CCA-IMT, significant differences were noted when comparing the CCA-IMT increment after 12 and 24 months post KTx in patients with normal (< or =15 micromol/l) and increased (>15 micromol/l) homocystein concentrations: p=0.049 and p=0.0039, respectively. Increment of CCA-IMT 12 months after KTx, significantly correlated with mean total cholesterol level (R=0.35; p=0.0333), whereas 24 months after procedure correlated significantly with 0.0315).
  
  
  CONCLUSIONS
  Hcy level is an independent risk factor for atherosclerosis development in patients after KTx. Elevated Hcy level as well as increased cholesterol and Lp(a) levels enhance the progression of atherosclerotic changes evaluated by CCA-IMT in KTx patients.
authors: Katedra i Klinika Nefrologii, Uniwersytet Jagielloński Collegium Medicum, Kraków. kasiajanda@op.pl
authors: Katarzyna
authors: K
authors: Janda
authors: Dariusz
authors: D
authors: Aksamit
authors: Maciej
authors: M
authors: Drozdz
authors: Marcin
authors: M
authors: Krzanowski
authors: Ewa
authors: E
authors: Ignacak
authors: Martyna
authors: M
authors: Kowalczyk-Michałek
authors: Barbara
authors: B
authors: Tabor-Ciepiela
authors: Władysław
authors: W
authors: Sułowicz
mesh_terms: D000293:Adolescent; D000328:Adult; D001055:Apolipoproteins B / Q000378:metabolism*; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D017536:Carotid Artery, Common / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D005260:Female; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D020138:Hyperhomocysteinemia / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D016030:Kidney Transplantation / Q000009:adverse effects*; D017270:Lipoprotein(a) / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D001055:Apolipoproteins B; D015415:Biomarkers; D017270:Lipoprotein(a); D006710:Homocysteine