LIPID ABNORMALITIES IN CARDIOVASCULAR MORBIDITY IN RENAL TRANSPLANT RECIPIENTS

心血管死亡和发病率仍然是主要的长期 肾移植受者的并发症 脂肪的重要性， 脂蛋白异常作为发展的危险因素 将评估心血管疾病。 除了总量，LDL和 HDL-胆固醇和甘油三酯，载脂蛋白A1和B的作用，Lp（a） 和脂蛋白组成（在患者的子集中）将被确定。 其他风险因素也将被衡量，因此，独立的影响 血脂和脂蛋白异常对长期预后的影响， 在这些研究中评估。 将进行三项相互依赖的研究。 1)所有儿童（< 18岁）肾移植受者将 在移植前和移植后进行连续观察。 它 假设血脂异常经常发生，并持续存在， 移植物功能良好。 2)一项对200名随机选择的成年人的横断面研究， 功能移植物1年将在第1年和第2年完成。 的频率和 将确定血脂异常的类型以及其他风险因素。 这些数据也将用于开发脂质的最终设计。 干预性试验 3)一项血脂干预试验将于第3年在成人中启动， 30-59岁，LDL-胆固醇水平升高。 血脂的影响 干预对心血管疾病死亡率和发病率的影响， 拒绝将被研究。 此外，降脂的安全性 药物，副作用的频率和与其他药物的相互作用将是 评估。

Cardiovascular death and morbidity continue to be major longterm complications in renal transplant recipients. The importance of lipid and lipoprotein abnormalities as risk factors for the development of cardiovascular disease will be assessed. In addition to total, LDL and HDL-cholesterol and triglycerides, the role of apoproteins A1 and B, Lp(a) and lipoprotein composition (in a subset of patients) will be determined. Other risk factors will also be measured and, thus, the independent effect of lipid and lipoprotein abnormalities on long term outcomes can be assessed in these studies. Three interdependent studies will be performed. 1) All pediatric ( < 18 years of age) recipients of renal transplants will be studied before and with sequential observations posttransplantation. It is postulated that lipid abnormalities occur frequently and persist despite good allograft function. 2) A crosssectional study of 200 randomly selected adults with a functioning graft 1 year will be done in years 1 and 2. The frequency and type of lipid abnormalities plus other risk factors will be determined. This data will also be used to develop the final design of the lipid interventional trial. 3) A lipid interventional trial will be initiated in year 3 in adults age 30-59 years with elevated LDL-cholesterol levels. The effect of lipid intervention on cardiovascular mortality and morbidity, and longterm rejection will be studied. Additionally the safety of lipid-lowering drugs, frequency of side effects and interaction with other drugs will be assessed.