Relationship between corticosteroid exposure and plasma lipid levels in heart transplant recipients

Becker, Diane M.; Chamberlain, Bruce; Swank, Robert T.; Hegewald, Michael G.; Baughman, Kenneth L.; Kwiterovich, P.; Pearson, Thomas A.; Ettinger, Walter H.

doi:10.1016/s0002-9343(88)80234-1

Cited by 111 publications

(37 citation statements)

References 35 publications

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“…[5] Lipid and lipoprotein changes with corticosteroids Dyslipidaemia, hyperglycaemia and hyper tension are the most significant cardiovascular adverse effects resulting from glucocorticoid therapy, [6] but mechanistic insights are incomplete. Documented changes in human lipid profiles on varying doses of prednisone [7][8][9][10] include elevated VLDL, TG and LDL cholesterol, and either increased or decreased HDL cholesterol.…”

Section: Reverse Cholesterol Transportmentioning

confidence: 99%

The influence of glucocorticoids on lipid and lipoprotein metabolism and atherosclerosis

Ross

Marais

2014

S Afr Med J

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Lipoproteins transport lipids in the circulation in four major pathways: (i) a postprandial (exogenous) pathway for chylomicrons; (ii) an endogenous pathway involving very-low-density lipoprotein (VLDL) for triglyceride (TG) transport from the liver; (iii) a lowdensity lipoprotein (LDL) pathway from a proportion of VLDL as a source of cholesterol for cells; and (iv) a reverse cholesterol transport pathway by high-density lipoprotein (HDL).[1] These pathways and the reported effects of glucocorticoids are shown in Fig. 1. Exogenous TG pathwayChylomicrons, comprising 85 -90% TG and containing apolipoprotein B (apo B)-48 (apoB48), apolipoprotein Ai (apoAi) and apolipoprotein Aiv (apoAiv), are produced in enterocytes, traverse the thoracic duct and ultimately reach the systemic circulation. Lipoprotein lipase anchored on cells by heparan sulphate proteoglycans hydrolyses TG at the vascular endothelium, yielding non-esterified fatty acids (NEFAs) and remnants, proportionately richer in cholesterol esters. Chylomicron remnants are rapidly cleared by liver remnant receptors, [2] as a result of apolipoprotein E (apoE) acquired in the circulation. Dietary fat restriction will have a significant impact on severe hypertriglyceridaemia.

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Section: Reverse Cholesterol Transportmentioning

confidence: 99%

The influence of glucocorticoids on lipid and lipoprotein metabolism and atherosclerosis

Ross

Marais

2014

S Afr Med J

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“…Sustained glucocorticoid treatment is known to promote hypertension, dyslipidemia, and glucose intolerance. 15 The impact of corticosteroids on the cardiovascular system has been well documented for patients undergoing transplants, 26 as well as for patients with systemic lupus and rheumatoid arthritis. 27,28 Souverein and colleagues 29 recently investigated the risk for CVD and cerebrovascular disease development in a large cohort of patients treated with glucocorticoids.…”

Section: Commentmentioning

confidence: 99%

Distribution of Low-Density Lipoprotein and High-Density Lipoprotein Subclasses in Patients With Sarcoidosis

Vekić

Zeljković

Jelić‐Ivanović

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Systemic inflammatory diseases are associated with proatherogenic lipoprotein profile, but there is a lack of information regarding overall distributions of lipoprotein subclasses in sarcoidosis.Objective.-To investigate whether patients with sarcoidosis have altered distributions of plasma low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particles.Design.-Seventy-seven patients with biopsy-proven sarcoidosis (29 with acute and 48 with chronic sarcoidosis) treated with corticosteroids and 77 age-and sex-matched controls were included in the study. Low-density lipoprotein and HDL subclasses were determined by gradient gel electrophoresis, while inflammatory markers and lipid parameters were measured by standard laboratory methods.Results.-Compared to controls, patients had fewer LDL I subclasses (P , .001), but more LDL II and III (P , .001) subclasses. This pattern was evident in both acute and chronic disease groups. Patients also had smaller HDL size (P , .001) and higher proportions of HDL 2a (P ¼ .006) and 3a particles (P ¼ .004). Patients with chronic sarcoidosis had smaller LDL size than those with acute disease (P ¼ .02) and higher proportions of HDL 3a subclasses (P ¼ .04) than controls. In acute sarcoidosis, relative proportions of LDL and HDL particles were associated with levels of inflammatory markers, whereas in chronic disease an association with concentrations of serum lipid parameters was found.Conclusions.-The obtained results demonstrate adverse lipoprotein subfraction profile in sarcoidosis with sustained alterations during disease course. Evaluation of LDL and HDL particles may be helpful in identifying patients with higher cardiovascular risk, at least for prolonged corticosteroid therapy due to chronic disease course.

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“…The levels of LDL-cholesterol and triglycerides begin to increase in the second postoperative week and reach a peak around the 3 rd to the 6 th month. Immunosuppressants, mainly cyclosporine and corticosteroids, seem to directly contribute to posttransplantation dyslipidemia [33][34][35][36][37] . Prednisone works by increasing the hepatic production of apolipoprotein B, predisposing the patient to insulin resistance, reducing the activity of the lipoprotein lipase, and decisively contributing to the weight gain observed in patients in the postoperative period 38 .…”

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confidence: 99%

Analysis of the risk factors for allograft vasculopathy in asymptomatic patients after cardiac transplantation

Bacal¹,

Veiga²,

Fiorelli³

et al. 2000

Arq. Bras. Cardiol.

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Relationship between corticosteroid exposure and plasma lipid levels in heart transplant recipients

Cited by 111 publications

References 35 publications

The influence of glucocorticoids on lipid and lipoprotein metabolism and atherosclerosis

The influence of glucocorticoids on lipid and lipoprotein metabolism and atherosclerosis

Distribution of Low-Density Lipoprotein and High-Density Lipoprotein Subclasses in Patients With Sarcoidosis

Analysis of the risk factors for allograft vasculopathy in asymptomatic patients after cardiac transplantation

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