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Lipoprotein distribution and composition in the human nephrotic syndrome
Atherosclerosis
|February 1, 1985
Summary
Nephrotic syndrome patients show altered plasma lipoproteins, with increased VLDL and LDL, and decreased HDL2b during active disease. These lipid changes suggest a higher risk for atherosclerosis.
Area of Science:
- Cardiology
- Nephrology
- Clinical Biochemistry
Background:
- Nephrotic syndrome is characterized by proteinuria, leading to complex alterations in plasma lipid metabolism.
- Understanding lipoprotein changes in nephrotic syndrome is crucial for assessing cardiovascular risk.
Purpose of the Study:
- To investigate plasma lipoprotein profiles in patients with nephrotic syndrome during active disease and remission.
- To analyze the distribution and composition of lipoprotein subclasses in nephrotic patients.
Main Methods:
- Quantitation of plasma lipoprotein profiles in 9 nephrotic syndrome patients.
- Comparison of lipid profiles during proteinuric phase versus remission phase.
- Separation and analysis of lipoprotein subclasses using isopycnic ultracentrifugation.
Main Results:
- Markedly increased plasma triglyceride, cholesterol, and apo B levels during the proteinuric phase.
- Elevated apo B-rich VLDL and LDL fractions, including a denser LDL subfraction.
- Decreased HDL2b and elevated HDL2a+3a and HDL3b+3c subclasses, leading to normal overall HDL cholesterol and apo A-I.
Conclusions:
- Nephrotic syndrome alters lipoprotein subclasses, characterized by atherogenic VLDL/LDL elevations and specific HDL redistribution.
- Despite normal overall HDL levels, the altered subclass distribution and decreased HDL2b cholesterol and apo A-I indicate increased atherosclerosis risk.
- Lipoprotein profiles normalize during remission, suggesting a link between proteinuria and dyslipidemia in nephrotic syndrome.