Abstract: Background/Aim. Proteinuria causes lipid metabolism abnormalities. The aim of the present study was to examine the influence of proteinuria on the lipoprotein (a) metabolism disorder. Methods. The study included 60 patients of the male-famele ratio (M : F = 32 : 28), mean age 37.15±9.85 years with, the average endogenous creatinine clearance 86.27±19.81 ml/min, and the average body mass index (BMI) 24.18±2.23 kg/m². Regarding the level of glomerular proteinuria, the patients were divided into four groups. The first (control) group, with proteinuria levels less than 0.25 g/24h, included 15 patients (M : F = 6 : 9), mean age 34.66±4.82 years, the mean clearance of endogenous creatinine 99.70±12.94 ml/min, and mean BMI 23.28±3.50 kg/m². The second group, with proteinuria between 0.25 and 1.0 g/24 h, includ 15 patients (M : F = 9 : 6) with primary glomerulonephritis, mean age 37.87±9.65 years, the mean clearance of endogenous creatinine 82.85±18.48 ml/min, and mean BMI 23.83±1.57 kg/m². The third group includ 15 patients (M : F = 8 : 7) with primary glomerulonephritis, with proteinuria between 1.0 and 3.0 g/24 h, mean age 35.67±13.29 years, the mean clearance of endogenous creatinine 82.85±18.48 ml/min, and mean BMI 23.83±1.57 kg/m². The fourth group, with proteinuria higher than 3.0 g/24 h, included 15 patients (M : F = 9 : 6) with primary glomerulonephritis, mean age 40.40±9.75 years, the mean clearance of endogenous creatinine 80.16±20.80 ml/min, and mean BMI 24.83±1.44 kg/m². In order to assess the influence of proteinuria on the lipoprotein (a) metabolism abnormalities we investigated 24-hour proteinuria, the colloid osmotic pressure (COP) of plasma, and the serum concentration of lipoprotein (a). The results were statistically analyzed using ANOVA, Kruscal-Wallis test, Mann-Whitney U test, χ² test and Spearman test. Results. Statistically, the patients with proteinuria over 3.0 g/24 h had the significantly higher values of lipoprotein (a) in serum as compared to the control group, and the patients with proteinuria about 0.25-1.0 g/24 h. The patients with proteinuria between 1.0-3.0 g/24 h had the statistically significantly higher values of lipoprotein (a) in serum than the control group (proteinuria < 0.25 g/24 h). There was a highly statistically significant negative correlation between serum albumin concentration, COP and the concentration of lipoprotein (a) in serum. There was a highly statistically significant positive correlation between 24-hour proteinuria and the concentration of lipoprotein (a) in serum. Conclusion. Proteinuria leads to the deterioration of lipoprotein (a) abnormalities. [ABSTRACT FROM AUTHOR]
Abstract: Uvod/Cilj. Proteinurija dovodi do poremećaja metabolizma lipida. Cilj rada bio je da ispita uticaj proteinurije na poremećaj metabolizma lipoproteina (a). Metode. U radu je ispitano 60 bolesnika (odnos mušakaraca i žena -- M : Ž = 32 : 28), prosečne starosti 37,15±9,85 godina, s prosečnim klirensom endogenog kreatinina 86,27±19,81 ml/min i prosečnim indeksom telesne mase 24,18±2,23 kg/m². U zavisnosti od stepena glomerulske proteinurije bolesnici su svrstani u četiri grupe. Prvu grupu, sa proteinurijom manjom od 0,25 g/24 h, činilo je 15 ispitanika (M : Ž = 6 : 9) prosečna starost 34,66±4,82 godine (kontrolna grupa). Drugu grupu, sa proteinurijom 0,25-1,0 g/24 h, činilo je 15 bolesnika sa primarnim glomerulonefritisom (M : Ž = 9 : 6), prosečne starosti 37,87±9,65 godina. Treću grupu, sa proteinurijom 1,0-3,0 g/24 h, činilo je 15 boleslnika sa primarnim glomerulonefritisom (M : Ž = 8 : 7), prosečne starosti 35,67±13,29 godina. Četvrtu grupu, sa proteinurijom većom od 3,0 g/24 h, činilo je 15 bolesnika sa primarnim glomerulonefritisom (M : Ž = 9 : 6), prosečne starosti 40,40±9,75 godina. Kao parametri za procenu uticaja proteinurije na poremećaj metabolizma lipoproteina (a) ispitivani su 24-satna proteinurija, koloidno-osmotski pritisak plazme i koncentracija lipoproteina (a) u serumu. Za statističku analizu dobijenih podataka korišćeni su jednofaktorska parametarska analiza varijanse -- ANOVA, Kruskal-Wallisov test, Mann-Whitney U test, χ² test i Spearmanov test rang korelacije. Rezultati. Bolesnici sa proteinurijom većom od 3,0 g/24 h imali su statistički visoko značajno veće vrednosti lipoproteina (a) u serumu u odnosu na kontrolnu grupu ispitanika i statistički značajno veće vrednosti u odnosu na grupu bolesnika sa proteinurijom od 0,25 do 1,0 g/24 h. Bolesnici sa proteinurijom od 1,0 do 3,0 g/24 h imali su statistički značajno veće vrednosti lipoproteina (a) u serumu u odnosu na kontrolnu grupu ispitanika (proteinurija < 0,25 g/24 h). Između koncentracije albumina u serumu, koloidno osmotskog pritiska i koncentracije lipoproteina (a) u serumu postojala je statistički visoko značajna negativna povezanost. Između 24-satne proteinurije i koncentracije lipoproteina (a) u serumu postojala je statistički visoko značajna pozitivna povezanost. Zaključak. Proteinurija dovodi do poremećaja metabolizma lipoproteina (a). [ABSTRACT FROM AUTHOR]
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