CORONARY ARTERY DISEASE RISKS IN AMERICAN & KOREAN POST RENAL TRANSPLANTATION

在美国，肾移植后患者中冠状动脉疾病(CAD)的发病率很高。肾移植患者患冠心病的风险比一般人高，这不仅是因为他们既有糖尿病、高血压、缺乏体力活动等并存疾病和上述类型的其他冠心病风险因素，还因为与移植状况有关的其他风险因素更高。这些疾病包括由于某些药物-营养相互作用导致的体重增加和高脂血症，以及长期使用免疫抑制剂，如泼尼松和环孢菌素。肾移植患者发生冠心病的免疫抑制相关风险包括高脂血症、体重快速增加、类固醇诱导的糖尿病、液体滞留和血清同型半胱氨酸水平的变化。同型半胱氨酸的升高，以及为了维持较低的同型半胱氨酸水平而降低B-维生素的饮食摄入量，都会进一步增加移植患者的冠心病风险。与许多针对美国患者的研究相比，关于韩国肾移植后患者饮食的研究寥寥无几。韩国患者的人口学特征、饮食摄入量、体重指数(BMI)、疾病、遗传背景等环境因素可能与美国患者不同。因此，在两国选定的配对患者之间检查这些特征和冠心病的危险因素是很有意义的。

There is a high prevalence of coronary artery disease (CAD) among post-renal transplant patients in the US. Renal transplant patients have higher risks for CAD than the general population not only because they have pre-existing co-morbidities such as diabetes, hypertension, physical inactivity and other CAD risk factors of the type mentioned above, but also because other risk factors related to transplant status are higher. These include weight gain and hyperlipidemia due to certain drug-nutrient interactions and chronic use of immunosupressants such as prednisone and cyclosporine. The immunosuppressant-related risks of CAD in post-renal transplant patients include hyperlipidemia, rapid weight gain, steroid induced diabetes, fluid retention and alterations of serum homocysteine levels. Elevated homocysteine and perhaps lower dietary intakes of B-vitamins to maintain low homocysteine levels further increase CAD risk among transplant patients. In contrast to the many studies of American patients, few studies of Korean post-renal transplant patients' diets are available. The demographic characteristics, environmental factors including dietary intakes, body mass index (BMI), disease, the genetic backgrounds of Korean patients and the dialytic techniques employed are likely to be different from those American patients. It is therefore of interest to examine these characteristics and risk factors for CAD between selected, matched patients in the two countries.