Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Unit of Internal Medicine, Department of Medical Sciences, IRCCS Casa Sollievo Della Sofferenza, Viale Cappuccini 1, 71013, San Giovanni Rotondo, FG, Italy.
J Nephrol. 2020 Oct;33(5):1001-1008. doi: 10.1007/s40620-020-00739-8. Epub 2020 Apr 23.
Chronic kidney disease is associated with altered lipid metabolism and lipid accumulation. Although it is though that hyperlipemia is a consequence of kidney dysfunction, several lines of evidence support that hyperlipidemia may contribute to the onset and progression of kidney disease, also in diabetes. This review describes the results of recent observational studies supporting the concept that glucose is only partly responsible for kidney damage onset, while a cluster of factors, including hypertriglyceridemia and low HDL-cholesterol, could play a relevant role in inducing onset and progression of DKD. We also report the results of randomized clinical trials investigating in type 2 diabetic patients the role of drug improvement of hypertriglyceridemia on renal outcomes. Finally, we discuss putative mechanisms linking hyperlipidemia (i.e. hypertriglyceridemia or low HDL cholesterol) with kidney disease.
慢性肾脏病与脂质代谢紊乱和脂质堆积有关。虽然高脂血症被认为是肾功能障碍的结果，但有几条证据支持高脂血症可能导致肾脏疾病的发生和进展，在糖尿病中也是如此。这篇综述描述了支持以下观点的最新观察性研究结果，即葡萄糖只是导致肾脏损伤发生的部分原因，而包括高三酰甘油血症和低高密度脂蛋白胆固醇在内的一组因素可能在诱导 DKD 的发生和进展中发挥重要作用。我们还报告了在 2 型糖尿病患者中研究药物改善高三酰甘油血症对肾脏结局影响的随机临床试验结果。最后，我们讨论了将高脂血症（即高三酰甘油血症或低高密度脂蛋白胆固醇）与肾脏疾病联系起来的潜在机制。
