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Nephrol Dial Transplant (1993) 8: 407-411
© 1993 European Renal Association-European Dialysis and Transplant Association

research-article

Decreased plasma lecithin: cholesterol acyltransfer and associated changes in plasma and red cell lipids in uraemia

M. P. T. Gillett1,, V. Teixeira1 and R. Dimenstein2

1Departamento de Bioquimica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco Recife 2Departamento Biomédico, Centro de Ciências Éxactas, Universidade Federal de Piauí Teresina, Brazil

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Michael P. T. Gillett, Department of Biochemistry, Faculty of Medicine and Health Sciences, United Emirates University, P.O. Box 17666, Al Ain, UAE

Plasma lipids, lecithin : cholesterol acyltransferase (LCAT) activity and erythrocyte lipid composition were compared for a group of newly diagnosed uraemic patients and a group of healthy subjects. Plasma triacylglycerol was increased and both total and high-density lipoprotein (HDL) cholesterol were decreased. A lower percentage of total cholesterol in patients' plasma was in the esterified form and plasma values of the phospholipid, lysolecithin, were also lower. The plasma LCAT activity of uraemic patients, whether expressed as nmol or percentage of cholesterol esterified per hour, was significantly lower than for normals. Both LCAT activity and lysolecithin in uraemic plasma were inversely correlated with the concentration of urea. The lipid composition of erythrocytes from patients was also abnormal, with both free cholesterol and lecithin being increased. These results are consistent with the occurrence of an acquired deficiency of LCAT in uraemia, comparable to that previously described in hepatic disease. The LCAT enzyme is secreted by the liver, and the inverse correlation noted in this study between LCAT activity and urea suggests that the increased urea in renal disease may inhibit the synthesis and secretion of the enzyme by the liver. The resulting reduction in LCAT activity may lead to the accumulation of cholesterol and lecithin in cell membranes and contribute to the overall pathophysiology of renal disease.

Keywords: cholesterol esterification; erythrocyte lipids; lecithin : cholesterol acyltransferase; uraemia


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