Abstract
It has been proposed that nephrotic syndrome is a consequence of an imbalance between oxidant/antioxidant statuses. The present study aimed to assess oxidant and antioxidant status in relation to dyslipidemia in children during remission and relapse phases of steroid sensitive nephrotic syndrome (SSNS). The study dealt with 40 children diagnosed as SSNS. They were categorized into two subgroups. The first subgroup included 25 children during remission stage. The second subgroup included 15 children during relapse. Control group consisted of age and gender-matched 15 healthy children. Significantly higher serum levels of malondialdehyde, oxidized LDL, total cholesterol, LDL cholesterol, triglycerides, apolipoprotein A-I, and apolipoprotein-B were observed in patients with SSNS especially in the relapsers. The serum levels of albumin, glutathione peroxidase activity, vitamin C, A, and E, and HDL cholesterol were significantly lower in patients especially among relapsers. In conclusion, a strong relationship between the oxidant/antioxidant status and dyslipidemia is documented in patients with SSNS, especially among relapsers. No normalization of the biochemical indices was observed despite the use of glucocorticoids. Therefore, the combined use of steroid, antioxidant therapy, and lipid lowering therapy can be recommended in such children.
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Abbreviations
- apo-A-I:
-
apolipoprotein A-I
- apo-B:
-
apolipoprotein-B
- CETP:
-
cholesterol ester transfer protein
- GSH-PX:
-
glutathione peroxidase
- HDL-C:
-
high-density lipoprotein cholesterol
- HMG-CoA:
-
hydroxy methyl glutaryl-CoA
- LpL:
-
lipoprotein lipase
- LDL-C:
-
low-density lipoprotein cholesterol
- MDA:
-
malondialdehyde
- MCNS:
-
minimal change nephrotic syndrome
- oxLDL:
-
oxidized low-density lipoprotein
- ROS:
-
reactive oxygen species
- SSNS:
-
steroid sensitive nephrotic syndrome
- TC:
-
total cholesterol
- TG:
-
triglycerides
- VLDL-C:
-
very Low-density lipoprotein cholesterol
References
Ece A, Atamer Y, Gurkan F, Davutoglu M, Kocyigit Y, Tutanc M 2005 Paraoxonase, total antioxidant response and peroxide levels in children with steroid-sensitive nephrotic syndrome. Pediatr Nephrol 20: 1279–1284
Kinra S, Rath B, Kabi BC 2000 Indirect quantification of lipid peroxidation in steroid responsive nephrotic syndrome. Arch Dis Child 82: 76–78
Mathew JL, Kabi BC, Rath B 2002 Anti-oxidant vitamins and steroid responsive nephrotic syndrome in Indian children. J Paediatr Child Health 38: 450–457
Ohtake T, Kumura M, Nishimura M, Hishida A 1997 Roles of reactive oxygen species and antioxidant enzymes in murine daunomycin induced nephropathy. J Lab Clin Med 129: 81–88
Zima T, Tesar V, Stipek S 1997 The influence of cyclosporine on lipid peroxidation and superoxide dismutase in adriamycin nephropathy in rats. Nephron 75: 464–469
Ece A, Atamer Y, Gurkan F, Bilici M, Kocyigit Y 2004 Anti-oxidant status in relation to lipoproteins, leptin and pro-inflammatory cytokines in children with steroid-sensitive nephritic syndrome. Nephrology 9: 366–373
Kronenberg F 2005 Dyslipidemia and nephrotic syndrome: recent advances. J Ren Nutr 15: 195–203
Merouani A, Levy E, Mongeau JG, Robitaille P, Lambert M, Delvin EE 2003 Hyperlipidemic profiles during remission in childhood idiopathic nephrotic syndrome. Clin Biochem 36: 571–574
Vicca S, Massy ZA, Hennequin C, Rihane D, Nguyen-Khoa T, Drueke TB, Lacour B 2003 New insights into the effects of the protein moiety of oxidized LDL (oxLDL). Kidney Int Suppl 63: S125–S127
Verrotti A, Basciani F, Trotta D, Pomilio MP, Morgese G, Chiarelli F 2002 Serum copper, zinc, selenium, glutathione peroxidase and superoxide dismutase levels in epileptic children before and after 1 y of sodium valproate and carbamazepine therapy. Epilepsy Res 48: 71–75
Buege JA, Aust SD 1978 Microsomal lipid peroxidation. Methods Enzymol 52: 302–310
Craig WY, Poulin SE, Nelson CP, Ritchie RF 1994 An ELISA method for the detection and quantization of IgG antibody against oxidized LDL: the effects of blocking buffer and the method of data expression on experimental findings. Clin Chem 40: 882–888
Doumas BT, Walson WA, Biggs HG 1971 Albumin standards and the measurement of serum albumin with bromocresol green. Clin Chim Acta 31: 87–96
Mills GC 1959 The purification and properties of glutathione peroxidase of erythrocyte. J Biol Chem 234: 502–506
Hafeman DG, Sunde RA, Hockstka W 1974 Effect of dietary selenium on erythrocyte and liver glutathione peroxidase in the rat. J Nutr 104: 580–587
Roe JH 1961 Standard Methods of Clinical Chemistry. III: Academic press, New York, pp 35
Nino HV, Parasad AS 1980 Vitamins and trace elements. In: Sonnenwirth AC, Leonard J (eds) Gradwohl's Clinical Laboratory Methods and Diagnosis. 8th ed. Mosby Company, St. Louis, Missouri, pp 368
Baker SJ, Pereira SM, Begum A 1968 Failure of vitamin E therapy in the treatment of anemia of protein-calorie malnutrition. Blood 32: 717–725
Assmann G, Jabs HV, Kohnert V, Nolte W, Schriewer H 1984 LDL-cholesterol determination in blood serum following precipitation of LDL with polyvinylsulfate. Clin Chim Acta 140: 77–83
Grove TH 1979 Effect of reagent pH on determination of HDL-cholesterol by precipitation with sodium phosphotungestate-magnesium. Clin Chem 25: 560–564
Allain CC, Poon LS, Chan CS, Richmond W, Fu PC 1974 Enzymatic determination of total serum cholesterol. Clin Chem 20: 470–475
Bucolo G, David H 1973 Quantitative determination of serum triglycerides by use of enzymes. Clin Chem 19: 476–482
Marcovina SM, Albers JJ, Dati F, Ledue TB, Richite RF 1991 International Federation of Clinical Chemistry Standardization Project for measurements of apo-A-I and B. Clin Chem 37: 1676–1682
Imakita M, Yutani C, Strong JP, Sakurai I, Sumiyoshi A, Watanabe T, Mitsumata M, Kusumi Y, Katayama S, Mano M, Baba S, Mannami T, Tanaka K 2001 Second nation-wide study of atherosclerosis in infants, children and young adults in Japan. Atherosclerosis 155: 487–497
Muntner P, Coresh J, Smith C, Eckfeldt J, Klag MJ 2000 Plasma lipids and risk of developing renal dysfunction. The atherosclerosis risk in communities study. Kidney Int 58: 293–301
Delvin EE, Merouani A, Levy E 2003 Dyslipidemia in pediatric nephrotic syndrome: causes revisited. Clin Biochem 36: 95–101
Diamond JR 1992 The role of reactive oxygen species in animal models of glomerular disease. Am J Kidney Dis 19: 292–300
Fydryk J, Jacobson E, Kurzawska O, Malecka G, Gonet B, Urasiński T, Brodkiewicz A, Bukowska H 1998 Antioxidant status of children with steroid sensitive nephrotic syndrome. Pediatr Nephrol 12: 751–754
Skrzep-Poloczek B, Tomasik A, Tarnawski R, Hyla-Klekot L, Dyduch A, Wojciechowska C, Wesolowski W, Kopieczna-Grzebieniak E, Zalejska-Fiolka J, Widera E 2001 Nephrotic origin hyperlipidemia, relative reduction of vitamin E level and subsequent oxidative stress may promote atherosclerosis. Nephron 89: 68–72
Bayse CA, Baker RA, Ortwine KN 2005 Relative strengths of se…N,O interactions; Implications for glutathione peroxidase activity. Inorganica Chim Acta 358: 3849–3854
Fydryk J, Olszewska M, Urasinski T, Brodkiewicz A 2003 Serum selenium level and glutathione peroxidase activity in steroid-sensitive nephrotic syndrome. Pediatr Nephrol 18: 1063–1065
Abdel Ghany SM, Sobh MA, Al-Kareemy EA, Abdul-Nassar MA, Kilani AI 1992 Evaluations of changes in lipid profile and thyroid hormones in nephrotic syndrome. Assiut Med J 16: 11–27
Kaysen GA, de Sain-van der Velden MG 1999 New insights into lipid metabolism in the nephrotic syndrome. Kidney Int Suppl 71: S18–S21
Shearer GC, Stevenson FT, Atkinson DN, Jones H, Staprans I, Kaysen GA 2001 Hypoalbuminemia and proteinuria contribute separately to reduced lipoprotein catabolism in the nephrotic syndrome. Kidney Int 59: 179–189
Kronenberg F, Lingenhel A, Lhotta K, Rantner B, Kronenberg MF, Konig P, Thiery J, Koch M, Von Eckardstein A, Dieplinger H 2004 Lipoprotein(a)- and LDL-derived cholesterol in nephrotic syndrome: Impact on lipid-lowering therapy?. Kidney Int 66: 348–354
Baxter JH, Goodman HC, Havel RJ 1960 Serum lipid and lipoprotein alterations in nephrosis. J Clin Invest 39: 455–465
Vaziri ND, Liang K, Parks JS 2001 Acquired lecithin-cholesterol acyltransferase deficiency in nephrotic syndrome. Am J Physiol Renal Physiol 280: F823–F828
Marsh JB, Welty FK, Lichtenstein AH, Lamon-Fava S, Schaefer EJ 2002 Apolipoprotein B metabolism in humans: studies with stable isotope-labeled amino acid precursors. Atherosclerosis 162: 227–244
Lee CM, Chien CT, Chang PY, Hsieh MY, Jui HY, Chau-Song Liau CS, Hsu SM, Lee YT 2005 HDL antagonizes oxidized LDL by suppressing oxygen free-radical formation and preserving nitric oxide bioactivity. Atherosclerosis 183: 251–258
Yoshino G, Hirano T, Nagata K 1993 Hypertriglyceridemia in nephrotic rats is due to clearance defect of plasma triglyceride: overproduction of triglyceride-rich lipoprotein is not an obligatory factor. J Lipid Res 34: 875–884
Kaysen GA, Pan XM, Couser WG, Staprans I 1993 Defective lipolysis persists in hearts of rats with heymann nephritis in the absence of nephrotic plasma. Am J Kidney Dis 22: 128–134
Barter PJ, Nicholls S, Rye KA, Anantharamaiah GM, Navab M, Fogelman AM 2004 Anti-inflammatory Properties of HDL. Circ Res 95: 764–788
Nayak SS, Bhaskaranand N, Baliga M, Venkatesh A, Aroor AR 1988 Serum HDL-cholesterol and urinary cholesterol in nephrotic syndrome. Indian J Med Res 88: 150–155
Zhang H, Huang WC, Tang SC 1994 (Serum apolipoprotein abnormalities in patients with idiopathic nephrotic syndrome). Zhonghua Yi Xue Za Zhi 74: 542–544, 582-583
Kim BJ, Hwang ST, Sung KC, Kim BS, Kang JH, Lee MH, Park JR 2005 Comparison of the relationships between serum apolipoprotein B and serum lipid distributions. Clin Chem 51: 2257–2263
Orzechowski A, Ostaszewski P, Wilczak J, Jank M, Balastinska B, Wareski P, Fuller JJ 2002 Rats with glucocorticoid-induced catabolic state show symptoms of oxidative stress and spleen atrophy: the effect of age and recovery. J Vet Med A Physiol Pathol Clin Med 49: 256–263
Iuchi T, Akaike M, Mitsui T, Ohshima Y, Shintani Y, Azuma H, Matsumoto T 2003 Glucocorticoid excess induces superoxide production in vascular endothelial cells and elicits vascular endothelial dysfunction. Circ Res 92: 81–87
Kawamura T, Yoshioka T, Bills T, Fogo A, Ichikawa I 1991 Glucocorticoid activates glomerular antioxidant enzymes and protects glomeruli from oxidant injuries. Kidney Int 40: 291–301
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El-Melegy, N., Mohamed, N. & Sayed, M. Oxidative Modification of Low-Density Lipoprotein in Relation to Dyslipidemia and Oxidant Status in Children With Steroid Sensitive Nephrotic Syndrome. Pediatr Res 63, 404–409 (2008). https://doi.org/10.1203/PDR.0b013e3181647af5
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DOI: https://doi.org/10.1203/PDR.0b013e3181647af5
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