The Changes Of Blood Lipids And Proteins Levels In Patients With Anemia

Background Anemia means a pathological state in which the erythrocyte volume ofthe whole body blood circulation is below the normal one. Studies imply thathypocholesterolemia accompanies anemias, such as thalassemia major, thalassemiaintermediate, sickle cell disease, glucose-6-phosphate dehydrogenase (G6PD)deficiency, spherocytosis, iron deficiency anemia and aplastic anemia. A few studieshave examined the association and significance of hypocholesterolemia related tohemoglobin and hematocrit. The pathophysiology of the hypocholesterolemia in thesesettings remains obscure, although several mechanisms have been proposed: increasedcholesterol requirement associated with erythroid hyperplasia, low hematocrit,decreased endogenous cholesterol synthesis by the liver and plasma dilution due toanemia.Objective To make a further investigation into the changes of serum lipids andproteins levels and the cause and clinical significance in patients with anemia, such asiron deficiency anemia(IDA), aplastic anemia(AA), anemia of chronic renal failure(ACRF).Method The data of collected85cases, such as IDA, AA, ACRF patients, were allfrom Qinghai University Hospital in late three years. The red blood cell, hemoglobin,hematocrit, serum total cholesterol (TC), triglycerides (TG), high-density lipoproteincholesterin (HDL-C), low-density lipoprotein cholesterin (LDL-C), total protein,albumin and globulin levels of these cases of untreated anemia patients and32healthysubjects (control group) were examined respectively．According to the type of anemia,we assigned patients to IDA, AA, ACRF group. In addition, we compared the severeanemia group with those of patients with mild and moderate anemia. Finally, weconducted correlation analysis between erythrocyte parameters and serologicaldetection.Results The serum TC levels of IDA and AA group were lower than that of thecontrol group (P <0.05) and ACRF group (P <0.01). At the same time, its level of severe anemia group was lower than that one of the control group while the serum TClevels of mild and moderate anemia group were lower than that of the former group (P<0.01). The serum LDL-C level of AA group was lower than that of the control group(P <0.05) and there was significant difference of the level of LDL-C between AA andACRF group (P <0.05). In addition, its level of severe anemia group was lower thanthat one of the control group, mild and moderate anemia group(P <0.01). The serumHDL-C levels of these groups were lower than that of the control group (P <0.01) andits levels of moderate and severe anemia group were lower than those of the controlgroup and mild group(P <0.01). The serum TG levels of IDA and AA group werelower than that of ACRF group (P <0.05). Meanwhile, the serum TP level of everygroup was lower than that of the control group (P <0.01) and its levels of moderateand severe anemia group were lower than that of the control group(P <0.01).Moreover, the serum A level of every group was lower than that of the control group(P <0.01) and the serum G level of AA group was lower than that of the control groupand IDA group (P <0.05). We examined the available data of all patients and foundsignificant correlation between each test index and erythrocyte parameter, such as TCand RBC(r=0.238), TC and Hb(r=0.477), TC and Hct(r=0.381), LDL-C andRBC(r=0.294), LDL-C and Hb(r=0.484), LDL-C and Hct(r=0.417), HDL-C andRBC(r=0.249), HDL-C and Hb(r=0.426), HDL-C and Hct(r=0.391), TG and Hb(r=0.218), TP and RBC(r=0.500), TP and Hct(r=0.348), A and RBC(r=0.286), G andRBC(r=0.390), G and Hct(r=0.266).Conclusions The level of serum TC in IDA and AA patients decreased. And thelevel of serum TC, LDL-C and HDL-C decreased gradually because of the reductionof hemoglobin. Also, the level of serum TC, LDL-C and HDL-C was positivelycorrelated with RBC, Hb and Hct. Thus, we conclude that the degree of anemia wasrelated to the level of serum TC, LDL-C and HDL-C. As a typical representative ofproliferative anemia, IDA patients are as same as AA patients whose marrow arefailure in the level of serum TC, LDL-C, HDL-C and TG. Therefore, we do notsupport another point of view, that is, the reproduction of red blood cells largelyenhances its demand for cholesterol in order to meet the need of synthesizing the red blood cell membrane. All the cases showed chronic malnutrition since their serumtotal protein and albumin levels decreased. The ACRF group was different from IDAand AA group and the level of serum HDL-C of this group decreased. Finally, wepoint out that the blood lipid changes in ACRF group were special since the chronicrenal failure might greatly affect the the levels of blood lipids.