Ling Yan, Li Xiaomu, Gu Qian, Gao Xin
Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, PR China.
Intern Med. 2011;50(24):2961-6. doi: 10.2169/internalmedicine.50.6216. Epub 2011 Dec 15.
Evidence from many studies suggests that dyslipidemia has a pathogenetic role in the development and progression of diabetic nephropathy. The objective of this study was to evaluate the relationships between serum lipid parameters and urinary albumin excretion in type 2 diabetic patients from Shanghai, China.
A total of 1094 type 2 diabetic patients were recruited. The urinary albumin to creatinine ratio (ACR), serum total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C), apolipoprotein A I (ApoA I), apolipoprotein B (ApoB), apolipoprotein E (ApoE) and lipoprotein (a) [Lp(a)] were measured and low density lipoprotein cholesterol (LDL-C) was calculated according to the Friedewald formula. An ACR of ≥30 µg/mg was defined as albuminuria, and <30 µg/mg as normoalbuminuria.
The levels of ApoE and triglyceride were significantly higher in albuminuric group compared with normoalbuminuric group (p<0.001 and p=0.003, respectively). Differences of ACR among the groups based on the tertile of ApoE and the tertile of triglyceride were significant (both p<0.001). In a multiple linear regression model, ApoE was independently associated with ACR (β=0.003, 95%CI 0.002-0.005, p<0.001).
Serum ApoE level was independently associated with urinary albumin excretion in type 2 diabetic patients from Shanghai, China.
多项研究证据表明，血脂异常在糖尿病肾病的发生和发展中具有致病作用。本研究的目的是评估中国上海2型糖尿病患者血清脂质参数与尿白蛋白排泄之间的关系。
共招募了1094例2型糖尿病患者。测量尿白蛋白与肌酐比值（ACR）、血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL-C）、载脂蛋白A I（ApoA I）、载脂蛋白B（ApoB）、载脂蛋白E（ApoE）和脂蛋白（a）[Lp（a）]，并根据Friedewald公式计算低密度脂蛋白胆固醇（LDL-C）。ACR≥30µg/mg定义为蛋白尿，<30µg/mg定义为正常白蛋白尿。
与正常白蛋白尿组相比，蛋白尿组的ApoE和甘油三酯水平显著更高（分别为p<0.001和p=0.003）。基于ApoE三分位数和甘油三酯三分位数分组的ACR差异具有统计学意义（均为p<0.001）。在多元线性回归模型中，ApoE与ACR独立相关（β=0.003，95%CI 0.002-0.005，p<0.001）。
在中国上海的2型糖尿病患者中，血清ApoE水平与尿白蛋白排泄独立相关。
