Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort
| Autor: | Rieko Kodera, Mitsuru Hosoya, Taito Oshima, Tsutomu Hirano, Toshiyuki Hayashi, Takeshi Hirashima, Natsuko Suzuki, Masahiro Fujita, Yasuki Ito, Ema Aoki, Noriyuki Satoh |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Urology Renal function urologic and male genital diseases Diabetic nephropathy chemistry.chemical_compound Diabetes mellitus Internal Medicine medicine Humans Diabetic Nephropathies Dyslipidemias Proteinuria Cholesterol business.industry Cholesterol LDL General Medicine medicine.disease Cross-Sectional Studies Diabetes Mellitus Type 2 chemistry Cardiovascular Diseases Cohort Female lipids (amino acids peptides and proteins) medicine.symptom business Dyslipidemia Lipoprotein(a) Lipoprotein |
| Zdroj: | Journal of Diabetes Investigation. 13:657-667 |
| ISSN: | 2040-1124 2040-1116 |
| Popis: | AIMS/INTRODUCTION Diabetic kidney disease (DKD) exacerbates dyslipidemia and increases the incidence of atherosclerotic cardiovascular disease. DKD is a concept that includes typical diabetic nephropathy and an atypical phenotype without proteinuria. We investigated dyslipidemia in different DKD phenotypes that have not been fully studied. MATERIALS AND METHODS Fasting plasma was obtained from 1,073 diabetes patients enrolled in the regional diabetes cohort (ViNA cohort). Non-proteinuric and proteinuric DKD were defined as an estimated glomerular filtration rate 300 mg/g. Novel lipid risk factors, low-density lipoprotein (LDL) triglyceride (TG) and small dense LDL cholesterol were measured using our established homologous assay. RESULTS The proportion of atherosclerotic cardiovascular disease patients was higher in non-proteinuric DKD and even higher in proteinuric DKD than in non-DKD. Increased estimated glomerular filtration rate grade and albuminuric stage were independently correlated with higher TG, TG-rich lipoprotein cholesterol and apolipoprotein CIII. Therefore, proteinuric DKD had the highest of these levels. Small dense LDL cholesterol and LDL-TG were higher in the proteinuria without renal dysfunction group in the lipid-lowering drug-free subset. Lipoprotein(a) was higher in DKD regardless of proteinuria. CONCLUSIONS Proteinuria was associated with an atherogenic subspecies of LDL, whereas renal dysfunction was associated with increased lipoprotein(a). Proteinuria and renal dysfunction independently exacerbated TG-rich lipoprotein-related dyslipidemia. This is in good agreement with the results of large-scale clinical studies in which proteinuria and renal dysfunction synergistically increased the risk of atherosclerotic cardiovascular disease in populations with diabetes. |
| Databáze: | OpenAIRE |
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