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Effect of probucol on hypercholesterolemia in renal transplant patients
1Department of Medicine, Sano Kohsei Hospital, Tochigi, Japan. michoh@lib.bekkoame.ne.jp
Background:
Hypercholesterolemia is a well-known complication in kidney transplant recipients, although its pathogenesis may be multifactorial. The therapeutic effect of probucol on post-transplant hypercholesterolemia was prospectively evaluated.
Methods:
Twelve hypercholesterolemic kidney transplant patients with serum total cholesterol > or = 250 mg/dl without diabetes mellitus or hypoproteinemia were prospectively treated with probucol (250 mg, bid, for three months). Before initiating and at the end of treatment, blood was drawn after at least a 12-hour fast to measure lipids in serum and lipoprotein fractions, apoproteins (apo), lipoprotein fractions, lethicin cholesterol acyl transferase (LCAT), free fatty acids (FFAs), and cholesterol ester. The lipid profiles of 17 healthy subjects were also examined.
Results:
After treatment with probucol, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and apo AI were significantly decreased, whereas cholesterol ester increased significantly.
Conclusions:
Post-transplant hypercholesterolemia is featured with abnormalities in very low-density lipoprotein (VLDL) metabolism. Although HDL cholesterol decreased, probucol might have acted as an antiatherogenic by modulating HDL metabolism and stimulating reverse transfer of cholesterol from peripheral tissue.