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Abnormal lipoprotein and apolipoprotein pattern in lipoprotein glomerulopathy

S Oikawa1, N Suzuki, E Sakuma

  • 1Second Department of Internal Medicine, Tohoku University School of Medicine, Japan.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|November 1, 1991
PubMed

Insights

Lipoprotein glomerulopathy involves abnormal lipid buildup in kidney glomeruli. High levels of apolipoprotein E appear linked to this rare renal disease and its characteristic lipoprotein thrombi.

Area of Science:

  • Nephrology
  • Lipidology
  • Pathology

Background:

  • Lipoprotein glomerulopathy is a rare renal disease characterized by "lipoprotein thrombi" in glomerular capillaries.
  • This condition has been identified in six patients through renal histology.

Purpose of the Study:

  • To investigate the clinical and biochemical characteristics of lipoprotein glomerulopathy.
  • To explore the association between apolipoprotein E levels, lipoprotein profiles, and the development of lipoprotein thrombi.

Main Methods:

  • Analysis of clinical data and renal histology from six patients with lipoprotein glomerulopathy.
  • Biochemical assays including lecithin-cholesterol acyltransferase (LCAT) activity, lipoprotein profiling, and plasma apolipoprotein E (apo E) levels.
  • Comparison with control groups: hyperlipidemic nephrotic syndrome without thrombi and type IIb hyperlipoproteinemia without renal disease.

Main Results:

  • All six patients exhibited proteinuria (1.6-10 g/d) and normal LCAT activity.
  • Patients presented with type III hyperlipoproteinemia-like lipoprotein profiles.
  • Significantly elevated plasma apo E levels (>10 mg/dL) were observed compared to controls (P < 0.01).
  • Apo E isoforms were predominantly rare (five E2/3, one E4/4), distinguishing it from familial type III hyperlipoproteinemia.

Conclusions:

  • Elevated apolipoprotein E levels, in conjunction with specific apo E isoforms and lipoprotein metabolic derangements, are strongly associated with lipoprotein glomerulopathy.
  • The findings suggest a causal link between apo E-related hyperlipoproteinemia and the formation of lipoprotein thrombi in the renal glomeruli.
  • Further research is warranted to elucidate the precise mechanisms connecting apo E metabolism and thrombus formation in this renal disease.

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