Acyl-Coenzyme A: Cholesterol Acyltransferase-1 Is Related To Hyperlipidemia In Children With Nephrotic Syndrome

Background: Hyperlipidemia is one of the characteristics of nephrotic syndrome, and cellular lipid accumulation in the kidney can accelerate kidney disease. ACAT1 plays important roles in cellular cholesterol homeostasis. The purpose of this study was to investigate the effect of ACAT1 on lipid metabolism in nephrotic syndrome, and its role in clinical diagnosis and efficacy evaluation.Methods: In this case control study, 30 patients with nephrotic syndrome and 30 healthy controls were enrolled. ACAT1 mRNA was detected by qPCR, and methylation of ACAT1 promoter was assayed by sodium bisulfite sequencing.Results: The expression of ACAT1 mRNA in NS group, remission group, and controls was 0.14 +/- 0.06, 0.08 +/- 0.03, and 0.08 +/- 0.04, respectively. The methylation of ACAT1 promoter in NS group, remission group, and controls was 2.27 +/- 2.71, 4.00 +/- 3.15, and 4.93 +/- 3.59, respectively. The AUC value of ACAT1 mRNA was 0.856 (95% CI: 0.760 - 0.951), while the AUC value of ACAT1 methylation was 0.653 (95% CI: 0.514 - 0.792). The results of Pearson's correlation suggested that the high expression of ACAT1 mRNA and the hypomethylation of ACAT1 were related to hyperlipidemia and hypoalbuminemia in nephrotic syndrome.Conclusions: This study shows that ACAT1 is related to hyperlipidemia and hypoproteinemia in nephrotic syndrome and can be a useful biomarker for the efficacy evaluation of nephrotic syndrome.