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Plasma apoM Levels and Progression to Kidney Dysfunction in Patients With Type 1 Diabetes

Nathaniel L Baker1, Samar M Hammad2, Kelly J Hunt1

  • 1Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.

Diabetes
|May 13, 2022
PubMed

Insights

Plasma apolipoprotein M (apoM) levels are linked to the development of diabetic kidney disease in type 1 diabetes. Higher apoM is associated with increased risk of macroalbuminuria and chronic kidney disease progression.

Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiovascular Research

Background:

  • Apolipoprotein M (apoM), a protein mainly transported by high-density lipoprotein (HDL), is implicated in cardiovascular disease and diabetic nephropathy.
  • Understanding the role of apoM in diabetic kidney disease (DKD) is crucial for early detection and intervention.

Purpose of the Study:

  • To investigate the association between plasma apoM levels and the progression of diabetic kidney disease.
  • To assess the relationship between apoM and the development of macroalbuminuria (MA) and chronic kidney disease (CKD) in individuals with type 1 diabetes.

Main Methods:

  • Plasma apoM levels were measured using enzyme immunoassay in 386 participants from the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) cohort.
  • Measurements were taken at DCCT entry and closeout, with follow-up for kidney dysfunction over 18 years of EDIC.

Main Results:

  • Elevated apoM levels at DCCT baseline were observed in patients who later developed CKD.
  • At DCCT closeout, significantly higher apoM levels were found in participants who progressed to MA, CKD, or both.
  • Increased apoM levels correlated with a higher risk of progression to MA (RR 1.30) and CKD (RR 1.69).

Conclusions:

  • Alterations in apoM and HDL composition/function in type 1 diabetes are present early in the disease.
  • Plasma apoM levels are associated with the development and progression of diabetic nephropathy.

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