state of the major circulating apolipoprotein B100-containing lipoproteins in patients with chronic renal failure and/or ischemic heart disease

ABSTRACT

The present study aimed at determining the major apolipoprotein B100 containing lipoproteins in CRF patients. These LDL subspecies are markers to lipid peroxidation, the key stone of atherosclerosis. Subjects and circulating levels of LDL-C/ HDL-C ratio, IDL [by sequential ultracentrifugation], Lp[a] [by ELISA] and MDA [by colorimetric method] were assessed in patients with CRF singly [30 cases] or combined with ischemic heart disease [15 cases] and in patients with sole IHD [15 cases]. Patients with CRF showed a significant increase in serum LDL-C concentrations and a significant decrease in HDL-C concentrations as compared with normals. Plasma IDL, Lp[a] and MDA median values were significantly higher than normal in the sole CRF, sole IHD and combined CRF with IHD. Serum TG and TC concentrations were significantly higher in patients with IHD singly than in sole CRF while HDL-C and LDL-C concentrations were similar in them. The serum levels of TC, TG, HDL-C and LDL-C in either IHD group and CRF+IHD group showed no significant differences in these groups. Also plasma Lp[a] and MDA concentrations were significantly higher in IHD patients than in controls. By multiple linear regression analysis, LDL-C/HDL-C ratio in all investigated cases was predictive indicator of abnormal IDL and Lp[a]. Conversely, Lp [a] value anticipated MDA concentrations. Although LDL-C/HDL-C ratio is known to influence atherogenesis, an avid relationship in between them is arguable due to different extrinsic and intrinsic confounding factors. However, measurement of LDL-C IHDL-C has been proposed as an appropriate first line investigations for diagnosis and therapeutic monitoring of IHD. Uremic dyslipidemia is not a simple association but promotes progression of CRF and accelerates atherosclerosis. High triglyceride-rich, apo B-containing lipoproteins [IDL and Lp[a]] may contribute avidly and independently to atheromatous process in chronic renal failure patients