Lipoprotein and hepatic lipase activity and high-density lipoprotein subclasses after cardiac transplantation

Abstract

Atherosclerosis is the leading obstacle to long-term survival in cardiac transplant patients. Increases in plasma triglycerides and lipoprotein cholesterol levels occur after transplantation that may contribute to transplant atherosclerosis. The etiology of this increase is unclear. We investigated the interaction of immunosuppressive medications with plasma triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, the HDL subclasses HDL 2 and HDL 3 cholesterol, and hepatic and lipoprotein lipase activity in 72 consecutive cardiac transplant patients compared to 51 healthy control subjects. In the transplantation group, greater concentrations of plasma triglyceride (80%, p < 0.001), LDL cholesterol (16%, p < 0.005) and hepatic lipase activity (100%, p < 0.001) were noted, whereas lipoprotein lipase activity was noted to be significantly lower (124%, p < 0.001). No difference was detected in HDL, HDL 2, or HDL 3 cholesterol. Cyclosporine dose was significantly associated with hepatic lipase activity (r = 0.33, p < 0.02) and inversely associated with lipoprotein lipase activity (r = −0.28, p < 0.05). Lipoprotein lipase activity after transplantation correlated inversely with triglycerides (r = −0.36, p < 0.002) and positively with HDL cholesterol (r = 0.23, p < 0.05) and HDL 2 cholesterol (r = 0.29, p < 0.05). Hepatic lipase activity correlated inversely with LDL cholesterol (r = −0.21, p < 0.08). In multiple regression analysis, cyclosporine dose was the major source of variation in hepatic lipase activity.