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ARTICLE
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Lipoprotein(a) Levels in the Nephrotic Syndrome Hiroaki Kanno, Eiji Saito, Takayuki Fujioka and Tadao Yasugi We investigated serum lipoprotein(a) [Lp(a)] levels in 20 patients with the nephrotic syndrome. Lp(a) levels in the nephrotic syndrome patients were significantly higher than those in a control group (30.4±22.5 vs 10.4± 17.7 mg/dl). Overall, the serum Lp(a) and lipid levels showed no relationship, but on an individual basis the serum Lp(a) level varied with the serum levels of total cholesterol and low density lipoprotein cholesterol in the nephrotic syndrome patients. Our findings suggest that a decrease in serum albumin led to increased hepatic Lp(a) synthesis. It is well known that thrombotic disease supervenes on hypercoagulability in the nephrotic syndrome, so the determination of Lp(a) levels in these patients may provide information which is useful for pre (Internal Medicine 31: 1004-1008, 1992) venting thrombotic complications. Key words: hyperlipoprotein(a)emia, hypoalbuminemia
Introduction Lipoprotein(a) [Lp(a)] is a low density lipoprotein-like particle carrying the apolipoprotein(a) glycoprotein (1 -3). Since its discovery by Berg in 1963 (4), many clinical studies have revealed a strong correlation between elevated serum Lp(a) concentrations and ischemic heart disease (5, 6). In 1987, McLean et al reported the close structural similarity of the apolipoprotein(a) moiety to plasminogen (7), and subsequent investigations have provided evidence for a rela tionship between Lp(a) and the fibrinolytic system (8, 9). The nephrotic syndrome regularly causes hyperlipidemia that is associated with an increase in atherogenicity (10-12). Appel et al previously reported that the decrease in the serum albumin concentration and osmotic pressure in this syndrome might be related to enhanced hepatic synthesis of lipoproteins containing apo B-100 (13). Furthermore, it is well known that thrombotic disease supervenes on hypercoagulability in the nephrotic syndrome (14, 15). Accordingly, we investigated Lp(a) levels in patients with the nephrotic syndrome. Subjects and Methods Twenty patients with the nephrotic syndrome (9 males and ll females) were studied. Their mean age was 36.1 ± 13.2 years. Needle biopsy of the kidney was per formed in 16 patients. Table 1 shows the clinical profiles
of the subjects. They were divided into two groups according to the serum albumin level (serum albumin >3.0 g/dl; normal albumin group, serum albumin
ARTICLE
å¡
Lipoprotein(a) Levels in the Nephrotic Syndrome Hiroaki Kanno, Eiji Saito, Takayuki Fujioka and Tadao Yasugi We investigated serum lipoprotein(a) [Lp(a)] levels in 20 patients with the nephrotic syndrome. Lp(a) levels in the nephrotic syndrome patients were significantly higher than those in a control group (30.4±22.5 vs 10.4± 17.7 mg/dl). Overall, the serum Lp(a) and lipid levels showed no relationship, but on an individual basis the serum Lp(a) level varied with the serum levels of total cholesterol and low density lipoprotein cholesterol in the nephrotic syndrome patients. Our findings suggest that a decrease in serum albumin led to increased hepatic Lp(a) synthesis. It is well known that thrombotic disease supervenes on hypercoagulability in the nephrotic syndrome, so the determination of Lp(a) levels in these patients may provide information which is useful for pre (Internal Medicine 31: 1004-1008, 1992) venting thrombotic complications. Key words: hyperlipoprotein(a)emia, hypoalbuminemia
Introduction Lipoprotein(a) [Lp(a)] is a low density lipoprotein-like particle carrying the apolipoprotein(a) glycoprotein (1 -3). Since its discovery by Berg in 1963 (4), many clinical studies have revealed a strong correlation between elevated serum Lp(a) concentrations and ischemic heart disease (5, 6). In 1987, McLean et al reported the close structural similarity of the apolipoprotein(a) moiety to plasminogen (7), and subsequent investigations have provided evidence for a rela tionship between Lp(a) and the fibrinolytic system (8, 9). The nephrotic syndrome regularly causes hyperlipidemia that is associated with an increase in atherogenicity (10-12). Appel et al previously reported that the decrease in the serum albumin concentration and osmotic pressure in this syndrome might be related to enhanced hepatic synthesis of lipoproteins containing apo B-100 (13). Furthermore, it is well known that thrombotic disease supervenes on hypercoagulability in the nephrotic syndrome (14, 15). Accordingly, we investigated Lp(a) levels in patients with the nephrotic syndrome. Subjects and Methods Twenty patients with the nephrotic syndrome (9 males and ll females) were studied. Their mean age was 36.1 ± 13.2 years. Needle biopsy of the kidney was per formed in 16 patients. Table 1 shows the clinical profiles
of the subjects. They were divided into two groups according to the serum albumin level (serum albumin >3.0 g/dl; normal albumin group, serum albumin
