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Atherogenic lipoprotein changes in diabetic nephropathy.

T Shoji1, M Emoto, T Kawagishi

  • 1Second Department of Internal Medicine, Osaka City University Medical School, 1-4-3 Asahi-machi, Osaka 545-8585, Abeno-ku, Japan. t-shoji@med.osaka-cu.ac.jp

Atherosclerosis
|June 8, 2001
PubMed
Summary

Diabetic nephropathy patients show lipoprotein changes, with renal failure impacting intermediate (IDL) and high-density (HDL) cholesterol more than albuminuria. These changes may increase cardiovascular risk.

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Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Cardiovascular disease risk is elevated in patients diagnosed with diabetic nephropathy.
  • Diabetic nephropathy is characterized by albuminuria and declining renal function.
  • Lipoprotein alterations are common in diabetes and may contribute to cardiovascular risk.

Purpose of the Study:

  • To investigate the distinct effects of albuminuria and renal failure on lipoprotein profiles in type 2 diabetes patients with nephropathy.
  • To identify which aspect of diabetic nephropathy—albuminuria or renal failure—is more strongly associated with atherogenic lipoprotein changes.

Main Methods:

  • Study included 160 healthy controls and 200 type 2 diabetes patients with varying degrees of nephropathy.
  • Patients were stratified into four groups based on urinary albumin/creatinine ratio (U-ACR) and serum creatinine (S-Cr) levels.

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  • Lipoprotein levels (VLDL, IDL, LDL, HDL) were quantified using ultracentrifugation.

    • Main Results:

    • Elevated very low-density lipoprotein cholesterol (VLDL-C) was observed across all diabetic nephropathy stages.
    • Intermediate-density lipoprotein cholesterol (IDL-C) increased with nephropathy severity, significantly in advanced stages (DM-3, DM-4).
    • High-density lipoprotein cholesterol (HDL-C) decreased, with a more pronounced reduction in patients with renal failure (DM-4).

    Conclusions:

    • Diabetic nephropathy is associated with significant alterations in lipoprotein metabolism, including elevated VLDL-C, IDL-C, and reduced HDL-C.
    • Elevated serum creatinine (renal failure) is an independent predictor of increased IDL-C and decreased HDL-C, suggesting a greater impact than albuminuria.
    • These lipoprotein abnormalities, particularly in the context of diabetic renal failure, likely contribute to the heightened cardiovascular risk in these patients.