Short- and long-term effects of lipoprotein apheresis on plasma hormones in patients with therapy-resistant dyslipidemia.
ACTH
Aldosterone
Apheresis
Cortisol
DHEAS
Lipoprotein
Low density lipoproteins
Renin
Testosterone
Journal
Atherosclerosis. Supplements
ISSN: 1878-5050
Titre abrégé: Atheroscler Suppl
Pays: Netherlands
ID NLM: 100973461
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
entrez:
11
12
2019
pubmed:
11
12
2019
medline:
26
5
2020
Statut:
ppublish
Résumé
Lipoprotein apheresis (LA) is a highly effective method to improve the clinical and metabolic situation in patients with therapy-resistant disorders of lipid metabolism. Cholesterol is the substrate for the synthesis of all steroid hormones. If repeated massive reduction of LDL-cholesterol may interfere with human adrenal steroidogenesis, and could become clinically relevant is unknown, so far. Thus, the aim of this study was to determine possible short- and long-term effects of LA on blood plasma levels of ACTH, cortisol, aldosterone, DHEAS, renin and testosterone. In total, 39 patients, treated with one of four LA techniques were studied: 1. Lipid Filtration (LF; n = 7), 2. Dextran Sulfate Adsorption (DSA; n = 7), 3. Membrane Filtration Optimised Novel Extracorporeal Treatment (MONET; n = 8), and 4. Direct Absorption of Lipoproteins (DALI; n = 15). Hormone levels were analyzed before and after five LA sessions with an interval of 20 weeks covering a total observation time of two years. In addition patients were comprehensively characterized by clinical and laboratory data. Patients treated with LA revealed an acute reduction of steroid hormones and ACTH, independent of apheresis technology but no long-term insufficiency in steroidogenesis was observed. Plasma renin levels were stable in LF patients and were highly elevated in patients under DSA, MONET and DALI apheresis throughout the observation period. In summary, these data suggest that although different LA techniques considerably differ in their acute effects on hormone levels during LA, they did not alter long-term hormone levels sustainably.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Lipoprotein apheresis (LA) is a highly effective method to improve the clinical and metabolic situation in patients with therapy-resistant disorders of lipid metabolism. Cholesterol is the substrate for the synthesis of all steroid hormones. If repeated massive reduction of LDL-cholesterol may interfere with human adrenal steroidogenesis, and could become clinically relevant is unknown, so far. Thus, the aim of this study was to determine possible short- and long-term effects of LA on blood plasma levels of ACTH, cortisol, aldosterone, DHEAS, renin and testosterone.
METHODS
METHODS
In total, 39 patients, treated with one of four LA techniques were studied: 1. Lipid Filtration (LF; n = 7), 2. Dextran Sulfate Adsorption (DSA; n = 7), 3. Membrane Filtration Optimised Novel Extracorporeal Treatment (MONET; n = 8), and 4. Direct Absorption of Lipoproteins (DALI; n = 15). Hormone levels were analyzed before and after five LA sessions with an interval of 20 weeks covering a total observation time of two years. In addition patients were comprehensively characterized by clinical and laboratory data.
RESULTS
RESULTS
Patients treated with LA revealed an acute reduction of steroid hormones and ACTH, independent of apheresis technology but no long-term insufficiency in steroidogenesis was observed. Plasma renin levels were stable in LF patients and were highly elevated in patients under DSA, MONET and DALI apheresis throughout the observation period.
CONCLUSIONS
CONCLUSIONS
In summary, these data suggest that although different LA techniques considerably differ in their acute effects on hormone levels during LA, they did not alter long-term hormone levels sustainably.
Identifiants
pubmed: 31818447
pii: S1567-5688(19)30065-0
doi: 10.1016/j.atherosclerosissup.2019.08.042
pii:
doi:
Substances chimiques
Cholesterol, LDL
0
Testosterone
3XMK78S47O
Aldosterone
4964P6T9RB
Dehydroepiandrosterone Sulfate
57B09Q7FJR
Adrenocorticotropic Hormone
9002-60-2
Renin
EC 3.4.23.15
Hydrocortisone
WI4X0X7BPJ
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
30-37Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.