Influence of proteinuria on disorders of lipoprotein metabolism

Abstract

In order to assess the role of proteinuria in the development of lipoprotein metabolism derangements, we investigated 60 patients (32 males and 28 females, mean age 37.15 ± 9.85 years, average clearance of endogenous creatinine 86.27 ± 19.81 mL/min, average body mass index 24.18 ± 2.23 kg/m 2), distributed in four groups according to degree of glomerular proteinuria. The control group, with urinary protein excretion <0.25 g/24h, included 15 persons, 6 males (M) and 9 females (F), average age 34.66 ± 4.82 years, with mean endogenous creatinine clearance (CCr) 99.70 ± 12.94 mL/min and mean body mass index (BMI) 23.28 ± 3.50 kg/m 2. Fifteen patients in the second group (M:F 9:6, average age 37.87 ± 9.65 years, mean CCr 82.85 ± 18.48 mL/min, mean BMI 23.83 ± 1.57 kg/m 2) had proteinuria of 0.25-1.0 g/24h. The third group included 15 patients (M:F 8:7, average age 35.67 ± 13.29 years, mean CCr 82.85 ± 18.48 mL/min, mean BMI 23.83 ± 1.57 kg/m 2), with proteinuria range 1.0 and 3.0 g/24h. The fourth group, with proteinuria greater than 3.0 g/24h, included 15 patients, M:F 9:6, mean age 40.40 ± 9.75 years, with mean CCr 80.16 ± 20.80 mL/min, and mean BMI 24.83 ± 1.44 kg/m 2. All patients in the second, third and fourth group had primary glomerulonephritis. Serum concentrations of the following parameters were measured: LDL cholesterol, HDL cholesterol, VLDL cholesterol and lipoprotein(a). Group differences were tested by the Student t-test, Mann-Whitney U test and c 2 test. Patients with proteinuria greater then 3.0 g/24h had significantly higher VLDL cholesterol (p<0.01) than subjects in other three groups. Furthermore, patients with proteinuria >3.0 g/24h had significantly higher serum HDL cholesterol (p<0.05) than control subjects. Serum lipoprotein (a) level was significantly greater in patients with proteinuria >3.0 g/24h as compared with patients with proteinuria ranging from 1.0 to 3.0 g/24h and control subjects (p<0.01). We therefore conclude that proteinuria causes disorders of LDL, VLDL, HDL and lipoprotein (a) metabolism.

Prevalence and study of lipid abnormalities in nephrotic syndrome attending a tertiary hospital, Nepal

“…However, Obrenovi R et al reported the significant proteinuria with low serum total protein and albumin. 19 Hypercholesterolemia was present in 75% (n=45). The mean cholesterol level was 9.54±4.60 (3.10-20.5mmol/l) which is similar to the finding of De Sain-van der Velden et al 20 Similarly, 15% had normal TG level, while 46.7% had >1.8-2.8mmol/l, 20% had >2.8-3.8 and 18.3% had more than 3.8mmol/L of serum TG level and the mean value of serum TG was=2.80±1.34 which was similar to De Sain-van der Velden et al study.…”

“…There is no significant correlation with 24hrs urinary protein with LDLc (p=0.18) whereas, there is significant correlation with HDLc (p=0.25). 19 TC/HDLc ratios were elevated and among them 70% had moderate to high risk for developing coronary artery diseases. Similar result had also been reported by Francisco AT et al 18 In present study, more than half (70% to 83.3%) of nephrotic patients are at moderate to high risk of developing coronary artery disease utilizing TC/HDL-C ratio.…”

Protein and Lipid Concentrations in Patients with Differentiated Thyroid Cancer Treated with Radioactive Iodine-131 / Koncentracija Proteina I Lipida Kod Pacijenata Sa Diferentovanim Karcinomom Štitaste Žlezde Koji Su Lečeni Radioaktivnim Jodom-131

“…A direct relationship between hypoalbuminemia and hyperlipidaemia has been reported, but in these studies, more profound decreases in albumin concentration were caused by nephritic syndrome (24,25,26), peritoneal dialysis (27) or hepatic dysfunction (28). Because the decline in protein concentration found in our 131-I-treated DTC patients was not as great as in the other specified conditions, the changes in lipid concentrations were also less pronounced.…”