Genetic factors play an important role in the pathogenesis of hyperlipidemia post-transplantation

Am J Kidney Dis. 2002 Jul;40(1):169-77. doi: 10.1053/ajkd.2002.33926.

Abstract

Background: Our purpose was to identify factors associated with hyperlipidemia post-transplantation in a Hispanic population.

Methods: From 1985 to 1999, a kidney graft survival longer than 3 months occurred in 293 cases at the Instituto Nacional de la Nutrición. Most of the patients living in Mexico City were included (n = 83). The evaluation included a questionnaire, blood samples, and assessment of body composition and dietary habits. As many as possible first-degree relatives were studied.

Results: Women had higher values of cholesterol (236 +/- 51 versus 215 +/-41; P < 0.05), low-density lipoprotein cholesterol (147 +/- 42 versus 131 +/- 34; P = 0.05), high-density lipoprotein cholesterol (57.3 +/- 14 versus 47.9 +/- 14; P = 0.002) and high-density lipoprotein-2 cholesterol. Isolated hypercholesterolemia was the most common lipid abnormality (40.9%), followed by mixed hyperlipidemia. Lipoprotein (a) greater than 30 mg/dL was found in 13 cases. Familial combined hyperlipidemia (FCHL) in the patient's relatives was a marker for dyslipidemia (odds ratio, 7.04; 95% confidence interval, 1.2 to 59.7). These cases had a worse lipid profile. Cyclosporine-treated FCHL patients had higher lipid levels compared with the non-FCHL, cyclosporine-treated patients. The effects of cyclosporine on the lipid levels were lower, but significant, after the exclusion of the FCHL cases.

Conclusion: Post-transplant dyslipidemia is determined by genetic and environmental factors. FCHL in the patient's relatives was associated with post-transplant hyperlipidemia; an additive effect with cyclosporine was found. The evaluation of the lipid profile of relatives may be useful for the assessment of the risk of post-transplant dyslipidemia.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Apolipoproteins E / genetics
  • Body Composition / genetics
  • Cholesterol / blood
  • Cholesterol / genetics
  • Cholesterol / metabolism
  • Cholesterol, HDL / blood
  • Cholesterol, HDL / genetics
  • Cholesterol, HDL / metabolism
  • Cholesterol, LDL / blood
  • Cholesterol, LDL / genetics
  • Cholesterol, LDL / metabolism
  • Contraindications
  • Cyclosporine / adverse effects
  • Cyclosporine / therapeutic use
  • Diet / adverse effects
  • Female
  • Genetic Predisposition to Disease*
  • Graft Survival / genetics
  • Humans
  • Hyperlipidemia, Familial Combined / blood
  • Hyperlipidemia, Familial Combined / drug therapy
  • Hyperlipidemia, Familial Combined / etiology
  • Hyperlipidemia, Familial Combined / genetics
  • Hyperlipidemias / blood
  • Hyperlipidemias / drug therapy
  • Hyperlipidemias / etiology*
  • Hyperlipidemias / genetics*
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Male
  • Mexico
  • Sex Factors
  • Surveys and Questionnaires

Substances

  • Apolipoproteins E
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Immunosuppressive Agents
  • Cyclosporine
  • Cholesterol