The correlation of serum homocysteine and lipid levels with renal function in renal transplant patients

Abstract

Objectives The relationship between homocysteine (Hcy) and lipid levels in renal transplant patients was analyzed to investigate the effect of hyperlipidemia on renal function and the importance of lipid monitoring in renal function after renal transplantation. Methods 492 patients outpatient follow-up of renal transplants from November 2014 to April 2015 in the Department of Urology and 221 healthy subjects from Shanghai First People′s Hospital were enrolled and their serum Hcy, Total cholesterol(TC), triglycerides(TG), High density lipoprotein cholesterol(HDL-C), Low density lipoprotein cholesterol(LDL-C) were tested.All the subjects were divided into normal group and abnormal group according to the serum Hcy levels. At the same time serum cysteine protease inhibitor C(CysC) level was tested to estimate glomerular filtration rate(eGFR), grouping according to the principle of Chronic Kidney Disease(CKD)《Kidney Disease Outcomes Quality Initiative》(KDOQI) staging criteria.The co-relationship between serum TC, HDL-C, TG, LDL-C levels and the possibilities of high cardiovascular risk factors, and the relationship between of serum Hcy and lipid levers, kidney function were analyzed based on the standard of 2007 China Adult dyslipidemia prevention and treatment guidelines . Statistical methods using U test、chi square analysis, correlation and multiple regression analysis. Results The serum TC(4.48-5.85), TG(1.05-1.91), HDL-C(1.33-2.01), LDL-C(2.53-3.72) and Hcy(11.99-20.23) levels in the renal transplantation group were higher than the control group′s TC(4.02-5.33), TG(0.81-1.74), HDL-C(1.11-1.58), LDL-C(2.21-3.32), Hcy(8.9-12.4) levels.(P=0.00, 0.00, 0.00, 0.00, P<0.01)In the renal transplantation group, serum Hcy levels was negatively correlated with eGFR and HDL-C levels (r=-0.565, -0.197, P<0.01), and was positively correlated with TG levels. (r=0.107, P<0.05) In renal transplantation group , the serum levels of HDL-C was significant lower in Hcy-abnormal group(1.15-1.77)than the normal group(1.35-1.97) (P=0.001, P<0.01), while the serum levels of LDL-C(2.51-3.93)was higher than the normal group(2.44-3.69)(P=0.023, P<0.05). In the renal transplantation group, the count ratio of lipid risk factors in the Hcy-abnormal group (0 item 55.4%, 1 item 23.5%, 2 items 14.2%, 3 items 6.5%, 4 items 0.4%)was higher than normal group(0 item 69.8%, 1 item 17.2%, 2 items 9.1%, 3 items 3.9%, 4 items 0.0%)(P=0.019, P<0.05). Ranked serum Hcy levels with cardiovascular risk factors, high-risk factors count ratio of eGFR 45-60 ml/min/1.73 m2 group was significant higher than eGFR 60-89 ml/min/1.73 m2 group in each level(P=0.018, P<0.05). Logistic regression analysis was carried out on the risk factors of serum TG, LDL-C, Hcy levels respectively, the results show that serum TG, LDL-C, Hcy levels and differences in renal function have statistical significance(P=0.00, 0.00, 0.00, P<0.01). Conclusions The serum TG, LDL-C and Hcy levels in the renal transplantation group were consistent increase and associated with kidney injury.The differences in TG, LDL-C, Hcy levels of renal transplant patients may cause differences in renal function after transplantation.Monitoring of serum lipids and Hcy levels is helpful for forecast the possibility of kidney injury.(Chin J Lab Med, 2016, 39: 690-694) Key words: Kidney transplantation; Homocysteine; Lipids; Glomerular filtration rate; Hyperlipidemias