Marked decrease of apolipoprotein A-V in both diabetic and nondiabetic patients with end-stage renal disease.

Apolipoprotein (apo) A-V has been the focus of significant attention as a potential modulator of plasma triglyceride (TG) in spite of its very low plasma concentration. TG levels are frequently elevated in patients with end-stage renal disease (ESRD), which is associated with a high prevalence of cardiovascular disease among them. We measured plasma apo A-V levels in 20 control subjects and 70 patients with diabetic and nondiabetic ESRD to investigate whether low apo A-V levels could be involved in the pathogenesis of the hyper-TG in ESRD. The plasma TG levels were significantly elevated in diabetic patients with ESRD, whereas those in nondiabetic ESRD patients remained similar to those in the controls. High-density lipoprotein cholesterol levels were significantly lower in the patients with ESRD than in the controls, irrespective of the presence of diabetes. Apo A-V levels measured by an enzyme-linked immunosorbent assay were markedly reduced to 40% to 44% of the control levels in both diabetic and nondiabetic patients with ESRD. The apo A-V levels were not correlated with TG in the overall study population, but they were positively correlated with high-density lipoprotein cholesterol. These results suggest that reduced apo A-V levels do not necessarily lead to hyper-TG in ESRD, but we are unable to exclude the possibility that low apo A-V plays a role in raising the TG level in diabetic ESRD.