| Study of Serum Lipids and Lipoprotein in Patients with Nephrotic Syndrome. |
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Eui Soo Park, Jeh Hoon Shin, Woo Gill Lee, Chong Moo Park |
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Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea |
| 신증후군 환아의 혈청 지질 및 지질단백 에 관한 연구 |
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박의수, 신재훈, 이우길, 박종무 |
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한양대학교 의과대학 소아과학교실 |
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| Abstract |
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The nephrotic syndrome is characterized by generalized edema, hypoproteinemia (serum albumin; below 2.5 gm/dl), hyperlipidemia (serum cholesterol; above 220 mg/dl), massive proteinuria (2.0 gm/M2/24 hrs or more). For causes of hyperlipidemia, decreased plasma lipoprotein lipase activity and decreased serum albumin have been postulated as contributing factors. So the serum lipids and lipoproteins were studied in 24 patients with nephrotic syndrome (confirmed by clinical and laboratory findings, or kidney biopsy), who were admitted to Hanyang University Hospital from December 1980 to June 1982. The results were as follows:
1) Before treatment, concentrations of serum total lipids, cholesterol, triglyceride, and phospholipid were 1,072.6±332.5 mg/dl, 379.2±133.8 mg/el, 311.3±116.4 mg/dl, and 339.4±89.5 dmg/dl, respectively.
After remission, the above results were 520.3±180.3 mg/dl, 177.5土40.2 mg/dl, 133.7±88.5 mg/dl, and 203.1±91.3 mg/dl, respectively; a significant decrease as compared with the lipid seen before treatment.
2) Concentrations of serum total lipids, cholesterol and phospholipid were significantly
negatively corelated with the level of serum albumin(r = — 0.62, p<0.01； r=—0.81, p<0.001; r=-0.64, p<0.01, respectively). Otherwise, the relationship between serum triglyceride and serum albumin was less regular than that of the other lipids(r=—0.41, p<0.05). 3) A significant relationship between cholesterol and phospholipid was noted (r = 0.90, r<0.001), but no relationship between cholesterol and triglyceride was noted (r=0.26, p> 0.05).
4) Serum lipoprotein electrphoresis were performed in all 24 cases.
Twenty-one of 24 cases had abnormal lipoprotein patterns, the rest (3 cases) had normal.
Before treatment, the composition percentage of a-lipoprotein, preß-lipoprotein, and ß-lipoprotein were 20.18±6.63%, 20.86±6.80%, and 59.38%±11.19%, repectively.
After remission, the above results were changed to 34.18±4.49%, 19.18±7.82%, and 45.94 :±8.78%, respectively. Therfore we made the observation that a-lipoprotein was increased after remission, and pre ß-lipoprotein was more increased in 4 cases which relapsed compared with patients before treatment.
5) By Fredrickson classification, 21 cases (88%) of abnormal lipoprotein patterns (hyperlipo-proteinemia) were as follows: type IIb-8 cases(38%), type ]y-8 cases(38%), type IIa-4 cases (19%), type V-l case(5%).
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| Key Words:
Nephrotic syndrome, lipid, lipoprotein |
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