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）的患病率很高。肾移植患者发生冠心病的风险高于一般人群，不仅因为他们存在糖尿病、高血压、缺乏运动等上述类型的冠心病危险因素，而且与移植状态相关的其他危险因素也更高。这些包括体重增加和高脂血症，由于某些药物-营养相互作用和长期使用免疫抑制剂，如强的松和环孢素。肾移植后患者发生CAD的免疫抑制相关风险包括高脂血症、体重迅速增加、类固醇诱导的糖尿病、体液潴存和血清同型半胱氨酸水平改变。升高的同型半胱氨酸和可能降低饮食中b族维生素的摄入量以维持低水平的同型半胱氨酸进一步增加移植患者冠心病的风险。与对美国患者的大量研究相比，对韩国肾移植后患者饮食的研究很少。韩国患者的人口学特征、环境因素（包括饮食摄入量、身体质量指数（BMI））、疾病、遗传背景以及采用的透析技术可能与美国患者不同。因此，在两个国家中选择匹配的患者中检查CAD的这些特征和危险因素是有意义的。

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.