CAJ | 학술논문

目的探讨血液透析患者脂代谢紊乱的临床特征及低密度脂蛋白受体相关蛋白(LRp)5'端四核苷酸重复序列基因多态性对脂代谢的影响.方法比较血液透析组患者(112例)与对照组(372例)血清TC、TG、HDL-C、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(Apo)A1、ApoB、ApoE及脂蛋白(Lp)(a)水平,聚合酶链反应-限制性片断长度方法检测LRP5'端四核苷酸重复序列基因多态性.结果血液透析组脂代谢紊乱主要表现为血清TG水平显著增高,HDL-C水平显著降低.血清TG水平高于正常者为37例(33.0%),HDL-C低于正常者为12例(10.7%).血液透析组高血压的发生率为73.6%(78/106),心血管疾病为25.0%(26/104).伴心血管疾病患者TG水平显著高于无心血管疾病患者,伴高血压患者与无高血压患者血脂水平差异无统计学意义.基因多态性分析显示,LRP 5'端四核苷酸重复序列基因型91/91、91/87与等位基因91 bp频率较高,2组间差异无统计学意义.血液透析组LRP5'端四核苷酸重复序列不同基因型间血脂水平差异无统计学意义.结论 TG水平与血清白蛋白水平、透析时体外循环血流量显著相关;HDL-C与尿素清除指数显著相关.LRP5'端四核苷酸重复序列基因多态性对血液透析患者血脂水平无显著影响.
목적 탐토혈액투석환자지대사문란적림상특정급저밀도지단백수체상관단백(LRp)5'단사핵감산중복서렬기인다태성대지대사적영향.방법 비교혈액투석조환자(112례)여대조조(372례)혈청TC、TG、HDL-C、저밀도지단백담고순(LDL-C)、재지단백(Apo)A1、ApoB、ApoE급지단백(Lp)(a)수평,취합매련반응-한제성편단장도방법검측LRP5'단사핵감산중복서렬기인다태성.결과 혈액투석조지대사문란주요표현위혈청TG수평현저증고,HDL-C수평현저강저.혈청TG수평고우정상자위37례(33.0%),HDL-C저우정상자위12례(10.7%).혈액투석조고혈압적발생솔위73.6%(78/106),심혈관질병위25.0%(26/104).반심혈관질병환자TG수평현저고우무심혈관질병환자,반고혈압환자여무고혈압환자혈지수평차이무통계학의의.기인다태성분석현시,LRP 5'단사핵감산중복서렬기인형91/91、91/87여등위기인91 bp빈솔교고,2조간차이무통계학의의.혈액투석조LRP5'단사핵감산중복서렬불동기인형간혈지수평차이무통계학의의.결론 TG수평여혈청백단백수평、투석시체외순배혈류량현저상관;HDL-C여뇨소청제지수현저상관.LRP5'단사핵감산중복서렬기인다태성대혈액투석환자혈지수평무현저영향.
Objective To investigate characteristics of dislipidemia and the effect of gene polymorphism of low density lipoprotein receptor related protein (LRP) tetranucleotide on hemodialysis patients. Methods Serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDLC),high density lipoprotein cholesterol (HDLC),apolipoproteins (Apo A1,B,E) and lipoprotein(a) [Lp(a)] were measured;polymerase chain reaction-restriction fragment length polymophism (PCR-RFLP) was used to detect LRP gene polymorphism in hemodialysis patients. Results Serum levels of TG and ApoB were significantly higher in the hemodialysis patients than those in contrals,and the levels of TC,LDLC,HDLC were lower compare to those in contrals. Patients with cardiovascular disease had higher TG level comparing to the patients without cardiovascular disease. The data of LRP polymorphism detected by PCR-RFLP showed that the allele frequency and the distribution of the LRP genotype of tetranucleotide reapeat sequence did not differ significantly between controls and hemodialysis patients. There was no statistic difference of serum lipid levels among hemodialysis patients with different genotype of LRP tetranucleotide.Conclusions Hemodialysis patients can develop hypertrglyeridemia and hypocholesteroldemia. TG level might be related to the development of cardiovascular disease in hemodialysis patients. The gene polymorphisms of LRP tetranucleotide dose not affect the lipid levels significantly in hemodialysis patients.