https://scholars.lib.ntu.edu.tw/handle/123456789/575503
標題: | Dyslipidemia in renal transplant recipients treated with a sirolimus and cyclosporine-based immunosuppressive regimen: Incidence, risk factors, progression, and prognosis | 作者: | SHIH-CHIEH CHUEH Kahan B.D. |
公開日期: | 2003 | 卷: | 76 | 期: | 2 | 起(迄)頁: | 375-382 | 來源出版物: | Transplantation | 摘要: | Background. This retrospective study compared the incidence, severity, and predisposing factors for dyslipidemia among renal transplant patients treated for up to 6 years with a cyclosporine ± prednisone-based concentration-controlled regimen without (n=118) or with (n=280) ascending exposures to sirolimus. Methods. The diagnosis of dyslipidemia was established when the serum cholesterol value (CHO) was more than 240 mg/dL or serum triglycerides (TG) were more than 200 mg/dL. Generalized estimating equations and mixed-modeling procedures were used for statistical analyses. Results. Hypercholesterolemia was observed in 46% to 80% and hypertriglyceridemia in 43% to 78% of sirolimus-treated patients during the first 6 posttransplantation months. The mean peak serum lipid levels among patients in the sirolimus group (CHO=285.5 mg/dL; TG=322.4 mg/dL) were significantly higher than those in the nonsirolimus group (CHO=250.2 mg/dL and TG=267.6 mg/dL; both P<0.01). The lipid values, which were persistently elevated during the first posttransplantation year, decreased slowly thereafter but remained significantly higher than the pretransplantation levels beyond 4 years after transplantation. The two forms of hyperlipidemia tended to occur in parallel (Pearson's coefficient of correlation, r= 0.5, P < 0.001), showing a positive predictive value of 0.67 and a negative predictive value of 0.65. However, there was no significant difference in the incidence of cardiovascular events within 4 years after transplantation among patients treated with versus without sirolimus. Conclusion. The dyslipidemia associated with sirolimus therapy, albeit persistent, does not seem to represent a major risk factor for the early emergence of cardiovascular complications. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0042768010&doi=10.1097%2f01.TP.0000074310.40484.94&partnerID=40&md5=83fd75dbe0699e68730fc205ad052976 https://scholars.lib.ntu.edu.tw/handle/123456789/575503 |
ISSN: | 0041-1337 | DOI: | 10.1097/01.TP.0000074310.40484.94 | SDG/關鍵字: | cholesterol; cyclosporin A; prednisone; rapamycin; triacylglycerol; adult; article; cardiovascular disease; cholesterol blood level; controlled study; correlation coefficient; disease predisposition; drug blood level; dyslipidemia; female; human; hypercholesterolemia; hyperlipidemia; hypertriglyceridemia; immunosuppressive treatment; kidney transplantation; major clinical study; male; priority journal; retrospective study; risk factor; triacylglycerol blood level; Adult; Anti-Inflammatory Agents; Cardiovascular Diseases; Cohort Studies; Cyclosporine; Disease Progression; Drug Therapy, Combination; Female; Humans; Hypercholesterolemia; Hypertriglyceridemia; Immunosuppressive Agents; Incidence; Kidney Transplantation; Male; Middle Aged; Prednisolone; Prognosis; Retrospective Studies; Risk Factors; Severity of Illness Index; Sirolimus |
顯示於: | 醫學系 |
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