Short- and long-term effects of lipoprotein apheresis on plasma hormones in patients with therapy-resistant dyslipidemia.
Atheroscler Suppl
; 40: 30-37, 2019 Dec.
Article
en En
| MEDLINE
| ID: mdl-31818447
ABSTRACT
BACKGROUND AND AIMS:
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:
In total, 39 patients, treated with one of four LA techniques were studied 1. Lipid Filtration (LF; nâ¯=â¯7), 2. Dextran Sulfate Adsorption (DSA; nâ¯=â¯7), 3. Membrane Filtration Optimised Novel Extracorporeal Treatment (MONET; nâ¯=â¯8), and 4. Direct Absorption of Lipoproteins (DALI; nâ¯=â¯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:
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:
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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Eliminación de Componentes Sanguíneos
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Dislipidemias
Tipo de estudio:
Observational_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Atheroscler Suppl
Asunto de la revista:
ANGIOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Alemania