Russo Giuseppina T, Giandalia Annalisa, Romeo Elisabetta L, Muscianisi Marco, Ruffo Maria Concetta, Alibrandi Angela, Bitto Alessandra, Forte Fiorella, Grillone Andrea, Asztalos Bela, Cucinotta Domenico
Department of Clinical and Experimental Medicine, University of Messina, Italy.
Department of Clinical and Experimental Medicine, University of Messina, Italy.
Diabetes Res Clin Pract. 2017 Oct;132:108-117. doi: 10.1016/j.diabres.2017.07.026. Epub 2017 Jul 28.
Diabetic kidney disease (DKD) and retinopathy (DR) develop in a considerable number of subjects with Type 2 Diabetes (T2D) despite the achievement of the recommended targets for glycaemia and blood pressure. Atherogenic dyslipidemia may play a relevant role, especially in T2DM women.
We report our findings on the effect of diabetic dyslipidaemia, the HDL subclasses distribution and the common cholesteryl ester transfer protein (CETP)TaqIB variant on the incidence or the progression of DKD and DR in 97 T2D women, after a ∼9years of follow-up.
At baseline, T2D women presented with low HDL-C levels and higher levels of large lipid rich α-1 (16.34mg/dl), α-2 (33.39mg/dl) and pre- α1 (4.81mg/dl) HDL subparticles. The CETP TaqIB polymorphism and baseline HbA1c, triglycerides, and HDL-C levels as well as specific HDL subpopulations were associated to the occurrence of RD after ∼9years of follow-up. At stepwise regression analysis, HbA1c, triglycerides and the less atheroprotective α-3 HDL particles were the only factors independently associated to the incidence of RD. These same variables were also associated with the progression from background to proliferative RD. BMI, LDL/HDL ratio and low levels of α-1 HDL particles were associated to the occurrence of DKD at univariate analysis, although BMI was the only significant predictor at stepwise multivariate regression analysis.
In T2D women, atherogenic dyslipidemia as well as subtle modifications in lipoprotein particles profile are associated with incidence and progression of microvascular disease.
尽管2型糖尿病（T2D）患者的血糖和血压达到了推荐目标，但仍有相当数量的患者会发生糖尿病肾病（DKD）和视网膜病变（DR）。致动脉粥样硬化性血脂异常可能起相关作用，尤其是在T2DM女性中。
我们报告了对97名T2D女性进行约9年随访后，糖尿病血脂异常、高密度脂蛋白亚类分布和常见胆固醇酯转运蛋白（CETP）TaqIB变体对DKD和DR发病率或进展的影响的研究结果。
在基线时，T2D女性呈现出低高密度脂蛋白胆固醇（HDL-C）水平以及较高水平的富含脂质的大α-1（16.34mg/dl）、α-2（33.39mg/dl）和前α1（4.81mg/dl）HDL亚颗粒。CETP TaqIB多态性以及基线糖化血红蛋白（HbA1c）、甘油三酯和HDL-C水平以及特定的HDL亚群与约9年随访后的视网膜病变（RD）发生相关。在逐步回归分析中，HbA1c、甘油三酯和动脉粥样硬化保护作用较弱的α-3 HDL颗粒是与RD发病率独立相关的唯一因素。这些相同变量也与从背景性DR进展为增殖性DR相关。在单因素分析中，体重指数（BMI）、低密度脂蛋白/高密度脂蛋白比值和低水平的α-1 HDL颗粒与DKD的发生相关，尽管在逐步多变量回归分析中BMI是唯一显著的预测因素。
在T2D女性中，致动脉粥样硬化性血脂异常以及脂蛋白颗粒谱的细微改变与微血管疾病的发生和进展相关。
