RELATION OF CYCLOSPORINE BLOOD-LEVELS TO ADVERSE-EFFECTS ON LIPOPROTEINS

Hyperlipidemia is common in renal allograft recipients. To elucidate t he role of cyclosporine in posttransplant hyperlipidemia, we measured lipids, lipoprotein lipids, and apolipoproteins of thirty-five renal a llograft recipients and evaluated their relation to trough cyclosporin e blood levels. Ah patients were on a triple immunosuppressive regimen with equal doses of prednisone and azathioprine, and had stable graft function. Cyclosporine blood levels were significantly correlated to total plasma cholesterol (P=0.028), low-density lipoprotein cholestero l (P=0.022), apolipoprotein B (P=0.017), and the cholesterol/high dens ity lipoprotein cholesterol ratio (P<0.002), but not to plasma triglyc erides. Significant inverse correlations were found between cyclospori ne blood levels and high-density lipoprotein cholesterol (P=0.034), hi gh-density lipoprotein(3) cholesterol (P=0.025), and apolipoprotein A- 1 (P=0.047), but not high-density lipoprotein(2) cholesterol. The inde pendent relation of cyclosporine blood levels to each of the measured lipid parameters was investigated by a stepwise regression model inclu ding age, body mass index, interval from transplantation, diabetes mel litus, plasma creatinine, and intake of diuretics and beta-blockers. A fter correction for these 7 variables, cyclosporine blood levels remai ned significantly associated with high-density lipoprotein cholesterol , high-density lipoprotein(3) cholesterol, apolipoprotein A-1, apolipo protein B, low-density lipoprotein cholesterol, and the cholesterol/hi gh-density lipoprotein cholesterol ratio. These data suggest that cycl osporine causes atherogenic dyslipidemia.