PMID- 35229896 OWN - NLM STAT- MEDLINE DCOM- 20230403 LR - 20230403 IS - 1365-2710 (Electronic) IS - 0269-4727 (Linking) VI - 47 IP - 7 DP - 2022 Jul TI - Analysis of serum lipid parameters predicting lipid metabolic disorders in TSC-AML patients with treatment of mTOR inhibitors. PG - 979-985 LID - 10.1111/jcpt.13631 [doi] AB - WHAT IS KNOWN AND OBJECTIVE: Patients with tuberous sclerosis complex (TSC) demonstrate disrupted lipid homeostasis before and during treatment with mammalian target of rapamycin (mTOR) inhibitor. However, few previous reports focused on if the serum lipid status at baseline would influence lipid metabolic side-effects of mTOR inhibitors for TSC associated renal angiomyolipomas (TSC-AML). The present study was designed to evaluate the predictive function of serum lipid status at baseline for hyperlipidaemia by mTOR inhibitor treatment in TSC-AML patients. METHODS: The clinical data of TSC-AML patients who took mTOR inhibitors in Department of Urology of Peking Union Medical College Hospital (PUMCH) from 1 January 2014 to 1 January 2021, were retrospectively analysed. The record of lipid parameters at baseline and the highest levels of total cholesterol (TC) and triglyceride (TG) after treatment at least >/=3 months were collected. The correlation of serum lipid parameters at baseline with incidence of hyperlipidaemia during mTOR inhibitor treatment was analysed. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the ability of the serum lipid parameters in predicting hyperlipidaemia. RESULTS AND DISCUSSION: 19 patients experienced hyperlipidaemia and 13 patients still had normal TC and TG levels during mTOR inhibitor treatment. The levels of high-density lipoprotein cholesterol (HDL-C) (0.98 +/- 0.30 mmol/L vs. 1.23 +/- 0.31 mmol/L, p = 0.030), low-density lipoprotein cholesterol (LDL-C) (2.47 +/- 0.69 mmol/L vs. 1.95 +/- 0.53 mmol/L, p = 0.029) and apolipoprotein B (ApoB) (0.82 +/- 0.21 g/L vs. 0.65 +/- 0.16 g/L, p = 0.019) are higher in the patients who experienced hyperlipidaemia during mTOR inhibition therapy. TC, TG, LDL-C, ApoB and high-sensitivity C-reactive protein (hsCRP) at baseline had positive correlation with TC after treatment; ApoB at baseline had positive correlation, while HDL-C and free fat acid (FFA) at baseline had negative correlation with TG after treatment. Therefore, ApoB concentration at baseline has statistically significant correlation with both TC (p < 0.001) and TG (p = 0.012) levels after mTOR inhibitor treatment. ROC curve and AUC revealed that ApoB with a cut-off value of 0.640g/L may be the best parameter for predicting hyperlipidaemia during mTOR inhibitor treatment in TSC-AML patients. The incidence rates of hyperlipidaemia were 27.3% and 76.2% among the patients with ApoB level 0.640 g/L respectively. WHAT IS NEW AND CONCLUSION: Some baseline serum lipid parameters could be used for predicting incidence of hyperlipidaemia during mTOR inhibition therapy in TSC-AML patients, and ApoB with 0.640 g/L as a cut-off value may be a potentially optimal indicator, which could help for diagnosis and treatment decision-making. CI - (c) 2022 John Wiley & Sons Ltd. FAU - Wang, Wenda AU - Wang W AD - Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wang, Zhan AU - Wang Z AD - Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Zhao, Yang AU - Zhao Y AD - Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wang, Xu AU - Wang X AD - Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Li, Hanzhong AU - Li H AD - Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Zhang, Yushi AU - Zhang Y AUID- ORCID: 0000-0002-8058-9702 AD - Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. LA - eng GR - 81670611/National Natural Science Foundation of China/ GR - pumch201911849/Youth Foundation of Peking Union Medical College Hospital/ PT - Journal Article DEP - 20220301 PL - England TA - J Clin Pharm Ther JT - Journal of clinical pharmacy and therapeutics JID - 8704308 RN - 0 (Apolipoproteins B) RN - 0 (Cholesterol, HDL) RN - 0 (Cholesterol, LDL) RN - 0 (Lipids) RN - 0 (MTOR Inhibitors) RN - EC 2.7.1.1 (MTOR protein, human) RN - W36ZG6FT64 (Sirolimus) RN - EC 2.7.11.1 (TOR Serine-Threonine Kinases) RN - 0 (Triglycerides) SB - IM MH - Humans MH - Apolipoproteins B MH - Cholesterol, HDL MH - Cholesterol, LDL MH - *Hyperlipidemias/chemically induced MH - *Leukemia, Myeloid, Acute MH - Lipids MH - MTOR Inhibitors MH - Retrospective Studies MH - Sirolimus MH - TOR Serine-Threonine Kinases MH - Triglycerides MH - *Tuberous Sclerosis OTO - NOTNLM OT - ApoB OT - TSC OT - hyperlipidaemia OT - mTOR inhibitors OT - prediction EDAT- 2022/03/02 06:00 MHDA- 2022/07/28 06:00 CRDT- 2022/03/01 08:42 PHST- 2022/01/04 00:00 [revised] PHST- 2021/10/04 00:00 [received] PHST- 2022/01/06 00:00 [accepted] PHST- 2022/03/02 06:00 [pubmed] PHST- 2022/07/28 06:00 [medline] PHST- 2022/03/01 08:42 [entrez] AID - 10.1111/jcpt.13631 [doi] PST - ppublish SO - J Clin Pharm Ther. 2022 Jul;47(7):979-985. doi: 10.1111/jcpt.13631. Epub 2022 Mar 1.