Serum Lipids and Lipoproteins in Type 2 Diabetic Patients with Persistent Microalbuminuria

Abstract

To investigate whether persistent microalbuminuria is related to altered levels of both lipids and apolipoproteins in Type 2 diabetes mellitus serum total-cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apolipoprotein A-I, and apolipoprotein B were measured by standard methods in a group of Type 2 diabetic patients affected by persistent microalbuminuria (albumin excretion rate (AER) 20-200 micrograms min-1) as compared with a group of sex- and age-matched non-microalbuminuric patients (AER less than 20 micrograms min-1). The groups were stratified according to a short (less than or equal to 5 years) or a longer (greater than 5 years) duration of diagnosed diabetes. Microalbuminuria was not associated with significant changes of serum total-cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, and apolipoproteins in the group of patients with a duration of disease greater than 5 years, while microalbuminuric patients less than or equal to 5 years from diagnosis (n = 11) had serum total-cholesterol, triglycerides, LDL-cholesterol, and apoprotein B higher than non-microalbuminuric control patients (n = 26) (cholesterol 6.2 +/- 0.9 vs 5.1 +/- 1.0 mmol l-1 (p = 0.003); triglycerides 2.1 +/- 0.7 vs 1.7 +/- 1.3 mmol l-1 (p = 0.03); LDL-cholesterol 4.1 +/- 0.8 vs 3.0 +/- 0.7 mmol l-1 (p less than 0.001); apo-B 1.3 +/- 0.3 vs 1.1 +/- 0.3 g l-1 (p = 0.02). In these patients with shorter duration of diabetes many of the serum lipid measures correlated positively with AER.

Effect of metabolic factors and blood pressure on kidney function in proteinuric Type 2 (non-insulin-dependent) diabetic patients

“…Other study groups have reported that raised triglyceride values were measured in the presence of microalbuminuria, whereas the findings with regard to total cholesterol varied [22,23]. In the present study it could be shown that the triglyceride level has an independent effect on the progression of nephropathy.…”

Prevalence of Microalbuminuria in Older-Onset Diabetes

“…This relationship has not been consistently found in NIDDM patients (30,48,49). In this study, an inverse relationship, of borderline significance (P = 0.08), between microalbuminuria and HDL cholesterol was established.…”

Prospective Study of Microalbuminuria as Predictor of Mortality in NIDDM

“…Furthermore, the predictive power of microalbuminuria was not demonstrated to be independent of either hypercholesterolemia or smoking, which are known to be important CVD risk factors in diabetes (21). Several studies have reported cross-sectional associations between plasma lipids and lipoproteins and albuminuria in IDDM (11,22) and NIDDM (12,23,24) and also between smoking and albuminuria in IDDM (10) and NIDDM (25). These factors could confound an apparent link between microalbuminuria and morbidity and mortality outcomes.…”