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LDL subclasses in IDDM patients: relation to diabetic nephropathy

S Lahdenperä1, P H Groop, M Tilly-Kiesi

  • 1Third Department of Medicine, University of Helsinki, Finland.

Diabetologia
|July 1, 1994
PubMed
Summary

Diabetic nephropathy in patients with insulin-dependent diabetes mellitus (IDDM) is linked to increased LDL-cholesterol. This elevation is mainly due to a higher number of LDL particles, not changes in their size or composition.

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Area of Science:

  • Endocrinology
  • Metabolic Syndrome
  • Nephrology

Background:

  • Diabetic nephropathy is a common complication of insulin-dependent diabetes mellitus (IDDM).
  • Elevated LDL-cholesterol is a known risk factor for cardiovascular disease in diabetic patients.
  • Understanding LDL particle characteristics in diabetic nephropathy is crucial for risk assessment.

Purpose of the Study:

  • To investigate changes in LDL particle size and composition in IDDM patients with varying stages of diabetic nephropathy.
  • To determine if elevated LDL-cholesterol in diabetic nephropathy is associated with altered LDL characteristics.

Main Methods:

  • Studied LDL particle distribution in normoalbuminuric, microalbuminuric, and proteinuric IDDM patients, and non-diabetic controls.
  • Utilized nondenaturing gradient gel electrophoresis to determine mean LDL particle diameter.

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  • Employed density gradient ultracentrifugation to analyze LDL composition and density distribution.
  • Main Results:

    • Normoalbuminuric IDDM patients exhibited larger LDL particles compared to controls.
    • LDL particle diameter showed an inverse correlation with serum triglycerides across all groups.
    • Increased LDL mass in microalbuminuric and proteinuric IDDM patients was primarily attributed to an increase in lighter LDL particles.

    Conclusions:

    • The elevation of LDL mass in incipient and established diabetic nephropathy is mainly due to an increased number of LDL particles.
    • No significant changes in LDL density distribution or composition were observed between diabetic groups.
    • These findings suggest that increased LDL particle number, rather than altered LDL characteristics, contributes to elevated LDL-cholesterol in diabetic nephropathy.