Unknown aspect of the old disease: does dyslipidemia in systemic AA amyloidosis differ from the dyslipidemia in primary glomerulonephritis?

Figures & data

Table 1. Laboratory characteristics of the patients with systemic AA amyloidosis and primary glomerulonephritis (PG) at the time of the diagnosis.

Characteristic	Systemic AA group, n = 43 (Mean ± SD)	PG group, n = 61 (Mean ± SD)	p
Age (years)	38.2 ± 15.8	35.8 ± 13.1	0.422
Gender, male n (%)	32 (74.4)	33 (54.1)	0.035
Total protein (g/L)	48.4 ± 10.9	55.5 ± 13.1	0.003
Salb (g/L)	20.5 ± 7.8	25.8 ± 8.7	0.002
SCr (µmol/L)	72.49 ± 19.45	73.37 ± 19.45	0.674
GFR (mL/min/1.73 m^2)	100.3 ± 24.7	99.4 ± 22.7	0.840
BMI (weight/height^2)	22.4 ± 4.0	26.3 ± 4.2	0.006
Proteinuria (g/day)	7.318 ± 3.112	7.361 ± 3.482	0.940
CRP (nmol/L)	3.84 ± 3.31	2.34 ± 1.04	0.001
Hemoglobin (g/L)	124 ± 21	139 ± 22	0.001
MCV (fl)	80.4 ± 6.9	85.5 ± 6.5	< 0.001
MPV (fl)	7.5 ± 1.1	8.2 ± 1.2	0.001
Platelet count (10^9/L)	418 ± 152	324 ± 106	0.002
TC (mmol/L)	6.86 ± 2.31	7.56 ± 3.29	0.230
TG (mmol/L)	2.37 ± 1.16	2.41 ± 1.47	0.880
LDL-C (mmol/L)	4.56 ± 2.05	5.49 ± 2.23	0.028
HDL-C (mmol/L)	1.19 ± 0.36	1.35 ± 0.39	0.035
LDL-C/HDL-C	4.07 ± 1.94	4.34 ± 1.97	0.500

Notes: PG, primary glomerulonephritis; Salb, serum albumin; SCr, serum creatinine; GFR, glomerular filtration rate; BMI, body mass index; CRP, C-reactive protein; MCV, mean corpuscular volume; MPV, mean platelet volume; TC, total cholesterol; TG, triglyceride; HDL-C, high density cholesterol; LDL-C, low density cholesterol.

Table 2. Distributions of serum lipid abnormalities in systemic AA amyloidosis and primary glomerulonephritis (PG).

Characteristic	Systemic AA group, n = 43, n (%)	PG group, n = 61, n (%)	p
Isolated hyper-LDL-C	5 (11.6)	12 (19.7)
Isolated hyper-TG	1 (2.3)	3 (4.9)
Isolated hypo-HDL-C	2 (4.7)	1 (1.6)
Hyper-LDL-C + hyper-TG	12 (27.9)	18 (29.5)	0.285
Hyper-LDL-C + hypo-HDL	2 (4.7)	4 (6.6)
Hyper-TG + hypo-HDL-C	5 (11.6)	1 (1.6)
Hyper-LDL-C + hyper-TG   + Hypo-HDL-C	10 (23.3)	18 (29.5)
Overall
Hyper LDL-C*	29 (67.4%)	52 (85.2%)	0.031
Hyper TG*	28 (65.1%)	40 (58.7%)	0.961
Hypo HDL-C*	19 (44.2%)	24 (39.3%)	0.621
Normal	5 (11.6)	3 (4.9)	0.208

Notes: PG, primary glomerulonephritis; TC, total cholesterol; TG, triglyceride; LDL-C, low density cholesterol; HDL-C, high density cholesterol.

*The data describe abnormal levels of the each parameter in overall cases.

Figure 1. Relation of serum LDL-C with serum total protein levels (A) in patients with primary glomerulonephritis etiologies and (B) in patients with systemic amyloidosis (LDL-C, mmol/L; serum total protein).

Figure 2. Relation of serum LDL-C with serum hemoglobin levels (A) in patients with primary glomerulonephritis etiologies and (B) in patients with systemic amyloidosis (LDL-C, mmol/L; hemoglobin g/L).

Table 3. Relationship of the serum lipid parameters with serum albumin, proteinuria and C-reactive protein in patients with systemic AA amyloidosis and primary glomerulonephritis (PG).

	TC		LDL-C		HDL-C		TG
	r	p	r	p	r	p	r	p
Systemic AA group
Proteinuria	0.19	0.200	0.05	0.750	0.01	0.920	0.37	0.010
Salb	−0.19	0.200	−0.11	0.470	0.06	0.660	−0.23	0.120
Total protein	−.0343	0.024	−0.292	0.057	0.081	0.605	−0.340	0.026
CRP	−0.09	0.560	−0.16	0.280	−0.15	0.300	0.02	0.900
Hb	0.34	0.020	0.40	0.008	0.39	0.008	0.05	0.710
MPV	0.24	0.110	0.07	0.650	0.26	0.080	0.01	0.930
PLT	0.07	0.620	0.25	0.090	−0.02	0.890	0.26	0.080
BMI	0.138	0.573	0.152	0.534	−0.134	0.303	0.180	0.461
GFR	−0.125	0.426	−0.101	0.507	−0.126	0.420	−0.324	0.034
PG Group
Proteinuria	0.33	0.009	0.42	0.001	0.23	0.07	0.32	0.012
Salb	−0.55	<0.001	−0.63	<0.001	−0.12	0.35	−0.43	<0.001
Total protein	−0.681	<0.001	−0.456	<0.001	−0.105	0.422	−0.459	<0.001
CRP	−0.05	0.666	−0.02	0.84	−0.02	0.83	0.15	0.24
Hb	0.33	0.08	0.19	0.13	0.08	0.51	0.24	0.058
MPV	0.04	0.70	0.09	0.482	0.058	0.65	0.02	0.82
PLT	0.07	0.57	0.01	0.91	−0.12	0.34	0.04	0.74
BMI	−0.320	0.181	−0.033	0.895	0.093	0.705	−0.066	0.788
GFR	−0.018	0.891	0.003	0.983	−0.018	0.892	0.056	0.668

Notes: PG, primary glomerulonephritis; TC, total cholesterol; LDL-C, low density cholesterol; HDL-C, high density cholesterol; TG, triglyceride; Salb, serum albumin and CRP, C-reactive protein, Hb, hemoglobin.

Table 4. A multivariate analysis of the overall patients with nephrotic proteinuria [both caused by systemic AA amyloidosis and primary glomerulonephritis (PG)].

	LDL-C		HDL-C		TG
	R^2: 0.391, F: 7.6, p < 0.001		R^2: 0.181, F: 8.5, p < 0.001		R^2: 0.294, F: 12.4, p < 0.001
	β	p Value	β	p Value	β	p Value
Gender, male*	–	–	2.47	0.002	–	–
Etiology of nephrotic syndrome, SAA*	−2.27	0.025	–	–	–	–
Age	–	–	–	–	–	–
Serum albumin	−2.30	0.024	–	–	–	–
Serum total protein	−2.58	0.012	–	–	−3.00	<0.001
Proteinuria	–	–	–	–	–	–
Hemoglobin	3.80	<0.001	2.94	0.001	2.57	0.004
CRP	–	–	–	–	–	–
GFR	–	–	–	–	–	–

Notes: The independent variables were gender, etiology of nephrotic syndrome, age, serum albumin, serum total protein, proteinuria, hemoglobin, CRP, GFR in all models for seperate dependent variables (LDL-C, HDL-C, TG). The empty cells implicate that the correlation of that dependent and independent variables are statistically not significant in multivariate analysis.

*Categorical variables.