The effect of tamoxifen treatment on serum cholesterol fractions in breast cancer women.

Serum levels of total, free, HDL- and LDL-cholesterol were determined in 45 postmenopausal breast cancer women treated with tamoxifen (TAM) from 6 to 73 months (mean duration of TAM treatment was 21.3 months) as an adjuvant therapy after mastectomy, and in the control group of 33 breast cancer women at the time of diagnosis before any treatment. The mean age of patients was 63 years in the TAM treated group and 70 years in the untreated breast cancer patients. TAM treated patients were found to have significantly lower concentration of serum total cholesterol (5.43 mmol/l vs. 6.44 mmol/l; p < 0.02) and LDL-cholesterol (3.54 mmol/l vs. 4.32 mmol/l; p < 0.01). There were 8 (18%) hypercholesterolemic patients in the TAM treated group vs. 13 (39%) in the untreated breast cancer patients (p < 0.05). No statistically significant differences were observed in serum concentrations of free and HDL-cholesterol in the two evaluated groups. We conclude that the TAM-induced changes in serum lipid concentrations are due to an estrogen-like activity of the agent and the reduction of total and LDL-cholesterol level seems to be an additional advantage of TAM treatment.

[Dynamics of changes in lipid metabolism during the first year after kidney transplantation]. / Dynamika zmian w metabolizmie lipidów w czasie pierwszego roku po przeszczepie nerki.

Dyslipidemia is one of the first metabolic dysfunction observed among patients with end stage renal disease. It can also induce acceleration of renal tissue damage. Kidney transplantation may cause recovery of some dysfunction in lipid metabolism while influencing deterioration of others. The aim of this study was to monitor dynamics of basic lipid parameters in the first year after kidney transplantation. The sample included 25 patients (9W, 16M), aged 18-59, avg. 36. We have measured concentration of the following parameters in blood serum: triglycerides (TG), total cholesterol (CH-C) and apolipoprotein B (Apo B). Simultaneously, functions of transplanted kidney were tested with use of routine methods. The immunosuppressive treatment of patients followed the scheme: cyclosporine + prednisolone + azathioprine. The treatment influence on lipid disorders was measured by relevant correlation coefficients. The obtained results point to the observation that in the first year after kidney transplantation the TG concentration gradually decreases, with simultaneous continuous increase of CH-C concentration, mainly due to LDL concentration increase. No influence of immunosuppressive treatment on lipid parameters was observed. However, lipid dysfunction, especially TG, correlated with kidney function.

Does immunosuppressive regimen influence the lipid disturbances in kidney recipients?

Though it is said that some immunosuppressive agents are implicated in the development of hyperlipidemia in kidney recipients, this subject is still controversial. Main plasma lipid parameters, as well as apolipoproteins A1 and B were measured periodically in 39 kidney first cadaveric, nondiabetic recipients during 24 months of clinic follow-up after transplantation. Standard triple immunosuppressive therapy: prednisone + cyclosporine + azathioprine was administrated from the beginning. After the second year of kidney transplantation, a significant reduction refers to values of TC, LDL, apo A1 and apo B. In the group with antirejection - methylprednisolone therapy, and without it only TG in the 24th month and apo B in the 1st month were statistically lower in the latter group (both p < 0.05). In the multiple regression test, a linear coincidence was observed between apo A1, apo B and prednisone cumulative dosage after the 1st month, TG and cyclosporine in the 6th month and LDL and cyclosporine in the 12th month after transplantation. It appears that steroids had an impact on lipids directly after transplantation, while cyclosporine did so thereafter.