Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Medical School, University of Zagreb, Croatia.
J Endocrinol Invest. 2013 Sep;36(8):574-8. doi: 10.3275/8850. Epub 2013 Feb 12.
Previous studies have suggested a positive association between dyslipidemia and chronic kidney disease, but sparse data are available on the relation of lipids and urinary albumin excretion rate (UAE) in normoalbuminuric patients with normal renal function.
The aim of this study was to evaluate the associations of serum lipids, including total, LDL, HDL, HDL2, HDL3 cholesterol, and triglyceride levels with UAE in normoalbuminuric Type 1 diabetic (T1D) patients.
Study included 313 normoalbuminuric T1D patients with normal renal function and before any interventions with statins, ACE inhibitors or angiotensin II receptor blockers. Subjects were classified as low-normoalbuminuric (UAE<11.0 mg/24h) or high-normoalbuminuric (UAE≥11.0 mg/24h) based on median UAE of at least two 24- h urine collections. Correlations and multiple linear regressions analysis were performed to identify relationships between serum lipids and UAE in normoalbuminuric subjects.
Total HDL (p=0.02) and HDL3 cholesterol (p=0.01) levels were higher in low-normoalbuminuric subjects compared to high-normoalbuminuric subjects. In logistic regression analysis, after adjustment for age, sex, BMI, duration of diabetes and HbA1c, lower total HDL and HDL3 cholesterol levels were significantly associated with risk of higher UAE in our normoalbuminuric subjects (p≤0.01), with odds ratios of 0.34 to 0.43.
Elevated total HDL and HDL3 cholesterol levels are associated with lower UAE in normoalbuminuric T1D patients. However, whether the detection of elevated total HDL and HDL3 cholesterol levels in T1D patients has protective value for development of microalbuminuria needs to be assessed in further follow-up studies.
先前的研究表明血脂异常与慢性肾脏病之间存在正相关关系，但有关肾功能正常的微量白蛋白尿患者血脂与尿白蛋白排泄率（UAE）之间关系的数据很少。
本研究旨在评估血清脂质（包括总胆固醇、LDL、HDL、HDL2、HDL3 胆固醇和甘油三酯水平）与 1 型糖尿病（T1D）患者微量白蛋白尿之间的相关性。
研究纳入了 313 例肾功能正常且未接受他汀类药物、ACE 抑制剂或血管紧张素 II 受体阻滞剂干预的微量白蛋白尿 T1D 患者。根据至少两次 24 小时尿液收集的 UAE 中位数，将受试者分为低微量白蛋白尿（UAE<11.0mg/24h）或高微量白蛋白尿（UAE≥11.0mg/24h）。对微量白蛋白尿受试者进行相关性和多元线性回归分析，以确定血清脂质与 UAE 之间的关系。
低微量白蛋白尿组的总 HDL（p=0.02）和 HDL3 胆固醇（p=0.01）水平高于高微量白蛋白尿组。在逻辑回归分析中，在校正年龄、性别、BMI、糖尿病病程和 HbA1c 后，总 HDL 和 HDL3 胆固醇水平较低与我们的微量白蛋白尿受试者 UAE 升高的风险显著相关（p≤0.01），比值比为 0.34 至 0.43。
升高的总 HDL 和 HDL3 胆固醇水平与微量白蛋白尿的 T1D 患者的 UAE 降低相关。然而，在进一步的随访研究中，需要评估 T1D 患者总 HDL 和 HDL3 胆固醇水平升高是否对微量白蛋白尿的发生具有保护价值。
