Recent advances in factors that alter lipid metabolism in chronic renal failure
Drüeke, T.; Lacour, B.; Roullet, J.B.; Funck-Brentano, J.L.
Kidney International. Supplement 16: S134-S138
1983
ISSN/ISBN: 0098-6577 PMID: 6588243 Document Number: 213987
Conclusions and speculations tentatively drawn from changes in lipoprotein composition and metabolism in uraemia are that: the presence of apolipoprotein (apo) B-48 in serum very-low-density lipoproteins (VLDL) and the high serum apo A-IV concentrations indicate a greater than normal contribution of alimentary remnant particles to the hypertriglyceridaemia of uraemic patients; the presence of apo E and C in triglyceride-enriched serum low-density lipoproteins (LDL), together with the triglyceride enrichment of all lipoproteins, probably stems from a deficiency of lipoprotein lipase (LPL) and hepatic lipase (HL) activity; the decreased ratio of serum apo C-II:C-III in VLDL is at least in part responsible for the depressed activity of LPL; the accumulation of lipoprotein particles with distorted apoprotein and lipid patterns (particularly beta -VLDL with enrichment in cholesterol) could be associated with increased atherogenesis because a recent study has shown a strong association between high serum intermediate-density lipoproteins and VLDL concentrations and the degree of coronary atherosclerosis; the increased apo E content of VLDL and high-density lipoprotein (HDL) in uraemic patients could particularly point to disturbed cholesterol metabolism because such lipoproteins could interact with LDL at apo B, E receptors; the decrease in serum HDL cholesterol has been shown to be strongly associated with atheromatous vascular disease and that could also hold for uraemic patients, but it is probable that low serum HDL cholesterol together with diminished capacity to form cholesterol-rich, apo E containing HDL represents a decrease in the antiatherogenic defence of the organism rather than increased atherogenic potential.