Atherosclerosis risk factors in young patients formerly treated for idiopathic nephrotic syndrome

Abstract

A total of 30 patients (ten female/20 male), 9 years to 22 years old (mean age 17.3 years) and 30 healthy teenage controls (mean age 16.4 years) were included in our study. The patients had steroid-sensitive idiopathic nephrotic syndrome (INS) and had completed steroid therapy 4 years to 15 years ago. Height and weight, body mass index (BMI), body composition, and intima-media thickness (IMT) were determined, as were levels of total cholesterol (TCh), low-density lipoprotein cholesterol (LDL-Ch), high-density lipoprotein cholesterol (HDL-Ch), triacylglycerols (TAGs), homocysteine (HCY), and high-sensitivity C-reactive protein (hsCRP). We did not observe any differences between the study and control groups in IMT (0.47 +/- 0.1 vs 0.46 +/- 0.1 mm) and body composition (fat tissue and water content). Differences in HDL-Ch and hsCRP levels between groups were not significant. In the study group we found significantly higher TCh levels (187.6 +/- 57.2 mg/dl vs 158.8 +/- 25.7 mg/dl; P = 0.012), LDL-Ch (115.9 +/- 63.7 mg/dl vs 79.4 +/- 25.4 mg/dl; P = 0.005), HCY (12.3 +/- 7.7 micromol/l vs 7.6 +/- 1.6 micromol/dl; P < 0.001), apolipoprotein B (ApoB) (113.6 +/- 30.0 mg/dl vs 78.7 +/- 13.6 mg/dl; P < 0.001) and ApoA1 (203.5 +/- 50.8 mg/dl vs 156.5 +/- 12.4 mg/dl; P < 0.001) levels. Multi-factor analysis of the influence of independent factors (number of recurrences, duration of remission, age, gender, and BMI) on the parameters under investigation indicated a positive correlation between IMT and the number of recurrences. 1. Patients treated for idiopathic nephrotic syndrome in the past should undergo regular laboratory tests of atherosclerosis risk factors, including not only cholesterol and its fractions, but also ApoA1, ApoB and HCY. 2. It is necessary to continue systematic check-ups of the intima-media thickness of the carotid arteries among young patients with anamnesis of INS, especially among patients who suffered from numerous relapses of this disease.