The Clinical Research On The Relationship Between Serum LCAT,HDL₂,HDL₃ And TCM Syndromes In Chronic Glomerulonephritis

Objectives : To observe the serum Lecithin:cholesterol acyltransferase (LCAT) activity, high-density lipoprotein cholesterol (HDL2 and HDL3)levels in patients with chronic glomerulonephritis (CGN). To explore the relationship of the serum LCAT activity, HDL2 and HDL3 levels to TCM syndromes in CGN.Materials and Methods: According to the standard in Chinese journal of internal medicine and national symposium of TCM, 95 patients (45 male and 50 female) with CGN, with an average age of 35.82 +15.26 years, were divided into four groups: Lung Qi and Kidney Qi Deficiency (LQKQD), Spleen Yang and Kidney Yang Deficiency (SYKYD), the Liver Yin and Kidney Yin Deficiency (LYKYD), and both Qi and Yin Deficiency (QYD). 30 healthy people (17 male and 13 female) were taken as the normal control group, with an average age of 34.18+16.29 years. The LCAT activity was determined by Sperry method on all patients and healthy people.Results: (1) The serum LCAT and HDL2 levels were markedly decreased in patients with CGN compared with the normal control group (P<0.01). (2) The serum total HDL level had no significant difference between the patients with CGN and the normal control group (P>0.05). The serum HDL3 levels in patients with CGN were significantly increased than those in the normal control group (P<0.01). (3) The levels of serum LCAT, HDL2 in CGN patients with LQKQD, SYKYD, LYKYD and SYKYD were markedly lower than those in control group(P<0.01), while the levels of HDL3 were markedly higher than those in control group(P<0.01). (4)The analysis of correlation showed that the LCAT activity, HDL2 and HDL3 level was obviously correlated to the concentration of clearance of endogenous creatinine (Ccr). And the levels of serum creatinine (Scr) and blood urinal nitrogen(BUN) were not correlated to the LCAT activity HDL2 and HDL3 levels.Conclusions: (1) The LCAT activity and HDL levels may offer a reference index to the TCM syndromes(LQKQD, SYKYD, LYKYD, QYD) in CGN. (2) The change of LCAT activity can influence the inversion of HDL3 into HDL2, which is related to the lipid metabolic disturbance in CGN. As an injury factor, it may be contributed to the development of CGN. (3) The level of LCAT, HDL2 and HDL3 can serve as reference index of the degree of kidney injury.