Lipoprotein Lipid Abnormalities in Healthy Renal Transplant Recipients: Persistence of Low HDL2 Cholesterol

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Abstract
There is disagreement about the prevalence and character of lipoprotein lipid abnormalities in renal transplant patients. To test the hypothesis that these abnormalities may be related to the coexistence of medical conditions and medications which affect lipoprotein metabolism in these patients, triglyceride (TG), cholesterol (C), high-density lipoprotein (HDL) and HDL-C subfractions were measured in 26 transplanted patients (10 F/16 M), control subjects matched for age, sex, weight and race and uremic patients being treated with hemodialysis. Female transplant recipients had higher TG (181 ± 47 vs. 68 ± 6 mg/dl; p < 0.001), C (242 ± 19 vs. 165 ± 9 mg/dl; p < 0.01), and low-density lipoprotein (LDL)-C (155 ± 15 vs. 93 ± 8 mg/dl; p < 0.01) than controls. Levels of HDL-C were similar, but HDL2 was significantly lower in the transplanted patients (9 ± 2 vs. 19 ± 2 mg/dl; p < 0.01). Compared to the uremic patients, female transplanted patients had higher C (242 ± 19 vs. 178 ± 22 mg/dl; p < 0.01), LDL-C (155 ± 15 vs. 94 ± 18 mg/dl; p < 0.01), HDL-C (51 ± 5 vs. 32 ± 4 mg/dl; p < 0.001) and HDL3-C (42 ± 4 vs. 26 ± 2 mg/dl; p < 0.001); however, HDL2-C levels were not significantly different. Similarly, male transplanted patients had higher TG (166 ± 26 vs. 100 + 12 mg/dl; p < 0.01), C (213 ± 10 vs. 158 ± 3 mg/dl; p < 0.01), LDL-C (126 ± 9 vs. 97 ± 3 mg/dl; p < 0.05) and HDL-C (54 ± 4 vs. 41 ± 3 mg/dl; p < 0.05) than controls and higher HDL (54 ± 4 vs. 36 ± 4 mg/dl; p < 0.05) and HDL3 (47 ± 3 vs. 30 ± 2 mg/dl; p < 0.05) than uremic patients. However, HDL2-C levels did not differ among the transplanted, control or uremic groups. Thus, both male and female renal transplant recipients who are otherwise healthy have elevated plasma TG, C and LDL-C and normal to high levels of HDL-C; however their HDL2-C levels are low. These abnormalities may explain why renal transplant recipients have an increased incidence of atherosclerotic vascular disease.