HIGH-DENSITY LIPOPROTEIN FUNCTIONALITIES IN PATIENTS WITH NEPHROTIC SYNDROME

 

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HIGH-DENSITY LIPOPROTEIN FUNCTIONALITIES IN PATIENTS WITH NEPHROTIC SYNDROME

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Hiroyuki
Suzuki
Hiroyuki Suzuki phillies4331@nifty.com Ozawa Hospital Division of Nephrology and dialysis Odawara Japan *
Masatsune Ogura enustasam@gmail.com Juntendo University Department of Clinical Laboratory Technology, Faculty of Medical Science Chiba Japan -
Eri Muso emuso@kki.biglobe.ne.jp Kyoto Kacho University Department of Food and Nutrition, Faculty of Contemporary Home Economics Kyoto Japan -
 
 
 
 
 
 
 
 
 
 
 
 

 We have reported that cholesterol efflux capacity (CEC) and anti-oxidative activity of high-density lipoprotein in non-nephrotic patients with chronic kidney disease (J Atheroscler Thromb. 2025. doi: 10.5551/jat.65662.). There is little information on abnormalities of high-density lipoprotein (HDL) function in patients with nephrotic syndrome (NS). This study is aimed to explore the alteration of cholesterol efflux capacity and anti-oxidative activity of HDL in patients with nephrotic syndrome.

 This retrospective cross-sectional observational study cohort included 515patients who underwent a kidney biopsy at Kitano Hospital. A total of 60 patients with nephrotic syndrome (median age: 60 (42, 68), male (50%) was recruited for the analysis. The remaining were recruited for the propensity score matching to adjust for baseline differences. CEC and oxygen radical adsorption capacity (ORAC) as anti-oxidative capacity were measured using serum obtained at the time of the kidney biopsy. Changes of CEC and ORAC in relation to the clinical and kidney injury parameters were evaluated.

 HDL-cholesterol level of patients with nephrotic syndrome  was 57 (48.2, 80) mg/dL. CEC and ORAC were 0.778 (0.645, 0.858) and 0.681 (0.605 0.764), respectively. Spearman’s coefficient analysis showed that body mass index (BMI) was significantly associated with CEC (ρ=-0.397, p=0.001) but not with ORAC (ρ=-0.115, p=0.371). Estimated glomerular filtration rate (eGFR) showed moderate association with CEC (ρ=0.453, p<0.001) but not with ORAC (ρ=0.04, p=0.721).  

 After adjusting for sex, age, statin use, BMI, and eGFR using propensity score matching, no significant difference in CEC was observed between the nephrotic syndrome (n=23) and non-nephrotic syndrome groups (n=23) (0.79 (0.57, 1.22) vs 0.89 (0.39, 1.03), p=0.240); however, ORAC was significantly lower in the nephrotic syndrome group (0.70±0.16 vs 0.86±0.17, p=0.002).

 CEC of minimal change nephrotic syndrome (MCNS, n=7) (0.846 (0.825, 0.953)) was significantly higher than diabetic nephropathy (DN, n=16) (0.721 (0.634, 0.759)), p=0.001 and membranous nephropathy (MN, n=12) (0.708 (0.630, 0.801)), p=0.009.

 ORAC of MCNS (0.562 (0.528, 0.629) was significantly lower than DN (0.721 (0.634, 0.759)), p=0.001, mesangial proliferative glomerulonephritis (GN, n=13) (0.736 (0.680, 0.865), p=0.018.

A multiple regression analysis showed that lower CEC was associated with higher BMI, lower eGFR and NS excluding MCNS, and that lower ORAC was associated with lower serum albumin and MCNS.

 Among the functional properties of HDL, its antioxidative capacity is notably reduced in patients with nephrotic syndrome, especially in MCNS, compared with non-nephrotic syndrome. HDL functional impairment might vary depending on the underlying disease.

Kewords