Low-density lipoprotein metabolism and its association to plasma lipoprotein(a) in the nephrotic syndrome

P. Stenvinkel, Lars Berglund, S. Ericsson, A. Alvestrand, B. Angelin, M. Eriksson

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Patients with nephrotic syndrome have multiple abnormalities of lipoprotein metabolism, but the cause and exact nature of these abnormalities have not been established. In the present study we have determined the kinetics of plasma low-density lipoprotein (LDL) apoB in seven nephrotic patients demonstrating an elevated LDL apoB production rate (25.7 ± 6.4 vs. 13.1 ± 0.3 mg kg-1 day-1; P < 0.001) but a normal LDL apoB fractional catabolic rate (FCR) (0.31 ± 0.04 vs. 0.33 ± 0.008 pools day-1; NS) compared with 41 healthy control subjects. However, two out of the seven patients had a markedly low LDL apoB-FCR. Serum albumin was inversely correlated with the LDL apoB production rate (R = -0.82; P < 0.05). Plasma lipoprotein(a) [Lp(a)] levels were significantly (P < 0.001) increased in the nephrotic patients compared with control subjects. Significant correlations were observed between log Lp(a) and LDL apoB production rate (R = 0.90; P < 0.01), VLDL-cholesterol (R = 0.95; P < 0.001) and VLDL-triglycerides (R = 0.80; P < 0.05) respectively. In summary, the present study suggests that nephrotic hyperlipidaemia may be caused by at least two independent mechanisms. The elevated LDL apoB production rate is highly correlated with the prevailing levels of serum albumin, whereas some nephrotic patients seem to have a decreased LDL apoB clearance, suggesting impaired LDL receptor-mediated clearance. The present results also suggest that the elevated plasma Lp(a) levels in nephrosis are related to an increased hepatic synthesis rather than a decreased catabolism of lipoproteins.

Original languageEnglish (US)
Pages (from-to)169-177
Number of pages9
JournalEuropean Journal of Clinical Investigation
Volume27
Issue number2
StatePublished - 1997
Externally publishedYes

Keywords

  • LDL kinetics
  • LDL-cholesterol
  • lipoprotein(a)
  • nephrotic syndrome
  • serum albumin

ASJC Scopus subject areas

  • Medicine(all)

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