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Relationship between lipid profiles and kidney function in patients with type 1 diabetes
N Tolonen1, C Forsblom, L Thorn
1Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki (C318b), University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014, Helsinki, Finland.
Diabetologia
|November 13, 2007
Summary
Patients with type 1 diabetes and impaired kidney function often have abnormal lipid profiles. Obesity, poor glycemic control, and hypertension also contribute to adverse lipid levels, with many patients not meeting LDL-cholesterol targets.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Medicine
Background:
- Type 1 diabetes is associated with various complications, including renal disease and dyslipidemia.
- International guidelines recommend specific lipid targets for diabetic patients to mitigate cardiovascular risk.
- Understanding the interplay between renal function, metabolic control, and lipid profiles is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between lipid profiles, estimated glomerular filtration rate (eGFR), and albuminuria (AER) in type 1 diabetes.
- To assess associations between lipid profiles and glycaemic control, obesity, and hypertension in patients without overt renal disease.
- To evaluate the attainment of international lipid targets in this patient cohort.
Main Methods:
- Analysis of lipid profiles from 2,927 adult patients with type 1 diabetes in the Finnish Diabetic Nephropathy Study (FinnDiane).
- eGFR calculated using the Cockcroft-Gault formula adjusted for body surface area.
- Stratification of patients based on renal function (eGFR levels) and presence of comorbidities.
Main Results:
- Impaired renal function (eGFR <60 ml/min/1.73 m²) was linked to significantly higher total cholesterol, triacylglycerol, apolipoprotein B, and lower HDL-cholesterol (p < 0.001).
- Adverse lipid profiles were also observed in patients without manifest renal disease who were overweight/obese, had poor glycaemic control, or hypertension.
- Only 14-43% of patients across groups met the recommended LDL-cholesterol target (<2.6 mmol/l).
Conclusions:
- Multiple lipid abnormalities are prevalent in type 1 diabetes, correlating with impaired renal function and abnormal AER.
- In patients without significant renal disease, obesity, glycaemic control, and hypertension are key determinants of dyslipidemia.
- A considerable proportion of type 1 diabetes patients fail to achieve guideline-recommended lipid targets, highlighting a need for improved management strategies.
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