Disorders in High-Density Metabolism With Insulin Resistance and Chronic Kidney Disease

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Cardiovascular risk increases with each decrement in renal function. Low-density lipoprotein (LDL) cholesterol levels are not associated with increased mortality, but high-density lipoprotein (HDL) levels are inversely associated with cardiovascular risk. Lipoprotein composition with increased abundance of small dense LDL and HDL and reduced levels of more buoyant isoforms is similar to what is found in states of insulin resistance and in the metabolic syndrome (MS). In both cases, high triglyceride levels are associated with reduced HDL levels. Chronic kidney disease (CKD) is itself associated with increasing insulin resistance as renal function fails. In both instances, decreased levels of apo A-I and apo A-II are a consequence of increased fractional catabolic rate (FCR), resulting from a predominance of small HDL particles. HDL maturation is impaired in CKD through decreased activity of lecithin:cholesterol acyltransferase (LCAT), and increased cholesterol ester transfer protein (CETP) activity in MS shuttles triglycerides back into HDL, thereby destabilizing it. Whether insulin resistance is entirely responsible for disorders of HDL metabolism in CKD, or whether the process is a result of unrelated pathophysiology, is currently unknown.

Original languageEnglish (US)
Pages (from-to)4-8
Number of pages5
JournalJournal of Renal Nutrition
Volume17
Issue number1
DOIs
StatePublished - Jan 2007

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high density lipoprotein
HDL Lipoproteins
kidney diseases
Chronic Renal Insufficiency
insulin resistance
Insulin Resistance
metabolism
metabolic syndrome
renal function
Triglycerides
triacylglycerols
cholesteryl ester transfer protein
phosphatidylcholine-choline acyltransferase
Apolipoprotein A-II
Cholesterol Ester Transfer Proteins
Phosphatidylcholine-Sterol O-Acyltransferase
Kidney
Apolipoprotein A-I
low density lipoprotein
pathophysiology

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Urology
  • Food Science
  • Clinical Neurology

Cite this

Disorders in High-Density Metabolism With Insulin Resistance and Chronic Kidney Disease. / Kaysen, George.

In: Journal of Renal Nutrition, Vol. 17, No. 1, 01.2007, p. 4-8.

Research output: Contribution to journalArticle

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