All issues > Volume 26(4); 1983

Original Article

J Korean Pediatr Soc. 1983;26(4):349-357. Published online April 30, 1983.

Study of Serum Lipids and Lipoprotein in Patients with Nephrotic Syndrome.

Eui Soo Park¹, Jeh Hoon Shin¹, Woo Gill Lee¹, Chong Moo Park¹

¹Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea

Abstract

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%).

Keywords :Nephrotic syndrome; lipid; lipoprotein