Decreased VLDL apoprotein CII/apoprotein CIII ratio may be seen in both normotriglyceridemic and hypertriglyceridemic patients on chronic hemodialysis treatment

Wakabayashi, Yasuhisa; Okubo, Michihito; Shimada, Hajime; Sato, Naoyuki; Koide, A; Marumo, Fumiaki; Nakamura, Haruo

doi:10.1016/0026-0495(87)90087-4

Cited by 28 publications

(12 citation statements)

References 21 publications

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“…The increased concentration of ApoE may indicate a true difference between CRF:1 and CRF:2 and CRF:HD patients with respect to this apolipoprotein. It should be pointed out, however, that ApoE levels of CRF:HD patients were found to be either ele vated [18] or unchanged [23,31] in comparison with con trol subjects; to our knowledge, there are no reports on the levels of ApoE in predialysis patients. Thus it appears that dialysis could ameliorate, at least to some extent, lipoprotein abnormalities considered to be atheroscle rotic in nature.…”

Section: Discussionmentioning

confidence: 70%

Lipid and Apolipoprotein Profiles of Uremic Dyslipoproteinemia -Relation to Renal Function and Dialysis

Attman

Alaupovic

1991

Nephron

174

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To study the effect of renal function on the development of lipid and apolipoprotein abnormalities in human renal disease, we have investigated 75 patients at different stages of renal insufficiency. The patient population consisted of 19 patients with less advanced renal failure (CRF:1) characterized by a mean glomerular filtration rate (GFR) of 37.4 ± 14 ml/min, 31 patients with advanced renal failure (CRF:2) having a mean GFR value of 7.9 ± 7.3 ml/ min and 25 patients on maintenance hemodialysis (CRF:HD). Patients in the CRF:1 group had normal plasma triglyceride (TG) and total cholesterol (TC) levels. In the CRF:2 and CRF:HD group, TG levels were increased two -to threefold, together with a moderate elevation of TC levels. All patient groups had elevated levels of VLDL cholesterol and slightly decreased levels of HDL cholesterol. The apolipoprotein profile of all patient groups was characterized by significantly reduced levels of apolipoprotein (Apo)A-I and ApoA-II and significantly increased levels of ApoC-III. CRF:2 and CRF:HD patients had also moderately elevated levels of ApoB, ApoC-I and ApoC-II. Levels of ApoE were only elevated in CRF:HD patients. All patients, regardless of TG levels, had significantly lower ApoA-I/ApoC-III ratios than controls. GFR was positively correlated with ApoA-I and inversely correlated with TC, TG and ApoC-III. CRF:HD patients had slightly higher ApoA-I and ApoA-II and lower ApoB levels compared to CRF:2 patients. Patients with vascular disease had higher TC, TG, ApoB, ApoC-II and ApoE than patients without vascular disease. These results demonstrate that the dyslipoproteinemia with CRF is already manifested at the early stages of disease through its abnormal apolipoprotein rather than lipid profile.

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Section: Discussionmentioning

confidence: 70%

Lipid and Apolipoprotein Profiles of Uremic Dyslipoproteinemia -Relation to Renal Function and Dialysis

Attman

Alaupovic

1991

Nephron

174

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“…Accordingly, an increased Apo CIIl/Apo E ratio was already detected in the VLDL and LDL of early uremic patients [11,27,28]. On the other hand, increased remnant LDL parti cles are a common feature in uremia and are thought to account for the type-III hyperlipo proteinemia frequently observed in these pa tients [3,25,26].…”

Section: Hyperlipidemia In Uremiamentioning

confidence: 99%

Lipoprotein Abnormalities in Chronic Renal Failure and Dialysis Patients

Monzani¹,

Bergesio

Ciuti

et al. 1996

Blood Purif

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Lipoprotein abnormalities are common in patients with chronic renal failure (CRF) on either dialysis or conservative therapy. In order to investigate the changes in lipid and apoli-poprotein pattern from early CRF to dialysis treatment, plasma lipids with apoproteins AI, B, E, CII, CIII, CII/CIII ratio, E/CII ratio, parathyroid hormone (PTH) and insulin levels were examined in 72 patients with different degrees of CRF and 31 patients on hemodialysis (HD), and compared the values of 28 controls. A significant decrease in the Apo CII/CIII ratio was the earliest lipoprotein abnormality to occur in CRF. Hypertriglyceridemia (HTG) with reduced high-density lipoprotein cholesterol levels, increased Apo CIII and decreased Apo E/Apo CIII ratio only occurred in more advanced renal failure (creatinine clearance < 31 ml/min). HD patients showed a general worsening of the lipoprotein profile with elevated Apo E levels and indirect evidence of remnant accumulation. While PTH did not have any significant influence on lipoprotein pattern, increased insulin levels during HD might partly account for the HTG of these patients. Our results point to elevated Apo CIII, reduced Apo CII/Apo CIII and Apo E/ Apo CIII ratios as typical features of uremic hyperlipidemia and show that a defective triglyceride removal is the major pathogenetic mechanism of uremic HTG. HD treatment seems generally to worsen the lipid and apolipoprotein pattern observed in the predialytic stage of CRF.

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“…Decreases in apo A-I and increases in apo C-III were found in CRF 39) . Uremic apo C-III was extremely sialic acid-rich, and the amount of its sub-components, such as apo C-III0, C-III1, and C-III2, varied from the respective control levels 40) .…”

Section: Chronic Renal Failure (Crf)mentioning

confidence: 93%