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[The apolipoprotein E gene polymorphism in children with steroid-resistant idiopathic nephrotic syndrome]
1Department of Nephrology, Guangzhou Children's Hospital and the Affiliated Children's Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120 P.R.China. huasongz@yahoo.com
Insights
Children with steroid-resistant nephrotic syndrome exhibit abnormal lipid metabolism and a higher frequency of the apolipoprotein E epsilon 2 allele, indicating increased cardiovascular disease risk. Antilipemic drug consideration is advised.
Area of Science:
- Pediatric Nephrology
- Genetics
- Cardiovascular Risk Factors
Background:
- Steroid-resistant idiopathic nephrotic syndrome (SRINS) affects children and is associated with significant health complications.
- Lipoprotein metabolism abnormalities are suspected in SRINS, but the role of apolipoprotein E (apoE) gene polymorphism requires further investigation.
Purpose of the Study:
- To investigate the association between apolipoprotein E gene polymorphism and lipid metabolism in children diagnosed with SRINS.
- To compare apoE genotypes and serum lipoprotein levels between children with SRINS and healthy controls.
Main Methods:
- A case-control study involving 60 children with SRINS and 80 healthy controls.
- Measurement of seven serum lipoprotein parameters: total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, apoAI, apoB, and Lp(a).
- Determination of apoE genotypes using polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP).
Main Results:
- Children with SRINS displayed significantly higher levels of serum TC, TG, HDL-C, LDL-C, apoAI, apoB, and Lp(a) compared to controls.
- The frequency of the apoE epsilon 2 allele was significantly higher in children with SRINS (11.66%) than in controls (5.00%).
- A notably higher apoE epsilon 2 allele frequency was observed in SRINS cases with focal segmental glomerulosclerosis (22.22%) compared to controls.
Conclusions:
- Children with SRINS exhibit pronounced and persistent abnormalities in serum lipoprotein metabolism.
- The increased prevalence of the apoE epsilon 2 allele in SRINS patients suggests a genetic predisposition.
- These findings highlight increased risks for atherosclerosis and cardiovascular diseases in children with SRINS, warranting consideration of antilipemic therapies.
Objective:
To study apolipoprotein E gene polymorphism in children with steroid- resistant idiopathic nephrotic syndrome (SRINS).
Methods:
Sixty children with SRINS (including 9 children with focalsclerosing glomerulonephritis) were observed in comparison with 80 age-sex-matched healthy children. Seven lipoprote in metabolism parameters including serum total-cholesterol(TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI(apoAI), apolipoprotein B (apoB), lipoprotein (a)[Lp (a)] were detected by enzyme method, and single-strand conformation polymorphism(PCR-SSCP) was used to determine the apoE genotypes in the two groups.
Results:
Serum TC, TG, HDL-C, LDL-C, apoAI, apoB, Lp(a) in the observation group were significantly higher than those in the healthy controls (P<0.01). After 6 months, the levels of serum TC, TG, LDL-C,apoB,Lp(a) were 81.25%, 78.13%, 84.38%, 87.50% and 78.13% respectively in 32 SRINS cases of the observation group. The apo epsilon 2 allele gene frequence was higher in the observation group than in the controls (11.66% vs 5.00%, P<0.05). The apo apsilon 2 allele gene frequence in the cases of focalsclerosing glomerulonephritis was significantly higher than that in the controls (22.22% vs 5.00%, P<0.01).
Conclusion:
The above results indicate the obvious and long term abnormalities of serum lipoprotein metabolism in the children with SRINS. The apo apsilon 2 allele gene frequence is higher in the children with SRINS. There are risk factors for atherosclerosis and cardiovascular diseases in the children with SRINS. The antilipemic drugs should be considered in use for the children with SRINS.