Association Between Plasma Triglycerides and High-Density Lipoprotein Cholesterol and Microvascular Kidney Disease and Retinopathy in Type 2 Diabetes Mellitus A Global Case-Control Study in 13 Countries

被引:221
作者
Sacks, Frank M. [1 ]
Hermans, Michel P. [2 ]
Fioretto, Paola [3 ]
Valensi, Paul [4 ]
Davis, Timothy [5 ]
Horton, Edward [6 ]
Wanner, Christoph [7 ]
Al-Rubeaan, Khalid [8 ]
Aronson, Ronnie [9 ]
Barzon, Isabella [3 ]
Bishop, Louise [1 ]
Bonora, Enzo [10 ]
Bunnag, Pongamorn [11 ]
Chuang, Lee-Ming [12 ]
Deerochanawong, Chaicharn [13 ]
Goldenberg, Ronald [14 ,15 ,16 ]
Harshfield, Benjamin [17 ]
Hernandez, Cristina [18 ,19 ]
Herzlinger-Botein, Susan [6 ]
Itoh, Hiroshi [20 ]
Jia, Weiping [21 ]
Jiang, Yi-Der [12 ]
Kadowaki, Takashi [22 ]
Laranjo, Nancy [17 ]
Leiter, Lawrence [23 ]
Miwa, Takashi [24 ]
Odawara, Masato [24 ]
Ohashi, Ken [25 ]
Ohno, Atsushi [26 ]
Pan, Changyu [27 ]
Pan, Jiemin [28 ]
Pedro-Botet, Juan [29 ]
Reiner, Zeljko [30 ]
Rotella, Carlo Maria [31 ]
Simo, Rafael [18 ,19 ]
Tanaka, Masami [20 ]
Tedeschi-Reiner, Eugenia [32 ]
Twum-Barima, David [33 ]
Zoppini, Giacomo [10 ]
Carey, Vincent J. [17 ]
机构
[1] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
[2] Catholic Univ Louvain, Clin Univ St Luc, B-1200 Brussels, Belgium
[3] Univ Padua, Dept Med, Padua, Italy
[4] Univ Paris Nord, Ctr Rech Nutr Humaine Ille France, Jean Verdier Hosp, Dept Endocrinol Diabetol Nutr,AP HP, Bondy, France
[5] Univ Western Australia, Crawley, Australia
[6] Harvard Univ, Sch Med, Joslin Diabet Ctr, Boston, MA 02115 USA
[7] Univ Wurzburg, D-97070 Wurzburg, Germany
[8] King Saud Univ, Coll Med, Riyadh 11461, Saudi Arabia
[9] LMC Diabet & Endocrinol, Toronto, ON, Canada
[10] Univ Verona, Dept Med, Endocrinol Sect, I-37100 Verona, Italy
[11] Ramathibodi Hosp, Bangkok, Thailand
[12] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan
[13] Rajavithi Hosp, Rangsit Sch Med, Bangkok, Thailand
[14] North York Gen Hosp, Toronto, ON, Canada
[15] LMC Diabet Ctr, Toronto, ON, Canada
[16] Endocrinol Ctr, Toronto, ON, Canada
[17] Brigham & Womens Hosp, Channing Div Network Med, Boston, MA 02115 USA
[18] CIBERDEM, Barcelona, Spain
[19] Vall dHebron Res Inst, Barcelona, Spain
[20] Keio Univ, Sch Med, Tokyo, Japan
[21] Shanghai Jiao Tong Univ, Affiliated Peoples Hosp 6, Shanghai Diabet Inst, Shanghai Clin Ctr Diabet, Shanghai 200030, Peoples R China
[22] Univ Tokyo, Dept Diabet & Metab Dis, Tokyo, Japan
[23] Univ Toronto, Toronto, ON, Canada
[24] Tokyo Med Univ, Tokyo 1608402, Japan
[25] Natl Canc Ctr, Dept Gen Internal Med, Tokyo, Japan
[26] Tokyo Med Univ, Hachioji Med Ctr, Tokyo 1608402, Japan
[27] Beijing 301 Mil Hosp, Beijing, Peoples R China
[28] Shanghai Jiao Tong Univ, Affiliated Peoples Hosp 6, Dept Endocrinol & Metab, Shanghai 200030, Peoples R China
[29] Univ Autonoma Barcelona, Hosp del Mar, E-08193 Barcelona, Spain
[30] Univ Zagreb, Univ Hosp Ctr Zagreb Sch Med, Dept Internal Med, Zagreb 41000, Croatia
[31] Univ Florence, Dept Clin Pathophysiol, Endocrinol Sect, Florence, Italy
[32] Univ Hosp Sestre Milosrdnice, Dept Ophthalmol, Zagreb, Croatia
[33] LMC Diabet & Endocrinol, Oakville, ON, Canada
关键词
diabetes mellitus; diabetic retinopathy; epidemiology; kidney; lipids; risk factors; INDEPENDENT RISK-FACTOR; CARDIOVASCULAR-DISEASE; SERUM-LIPIDS; ATHEROSCLEROSIS RISK; APOLIPOPROTEIN-CIII; RENAL DYSFUNCTION; MACULAR EDEMA; HYPERTRIGLYCERIDEMIA; COMPLICATIONS; ALBUMINURIA;
D O I
10.1161/CIRCULATIONAHA.113.002529
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Microvascular renal and retinal diseases are common major complications of type 2 diabetes mellitus. The relation between plasma lipids and microvascular disease is not well established. Methods and Results The case subjects were 2535 patients with type 2 diabetes mellitus with an average duration of 14 years, 1891 of whom had kidney disease and 1218 with retinopathy. The case subjects were matched for diabetes mellitus duration, age, sex, and low-density lipoprotein cholesterol to 3683 control subjects with type 2 diabetes mellitus who did not have kidney disease or retinopathy. The study was conducted in 24 sites in 13 countries. The primary analysis included kidney disease and retinopathy cases. Matched analysis was performed by use of site-specific conditional logistic regression in multivariable models that adjusted for hemoglobin A(1c), hypertension, and statin treatment. Mean low-density lipoprotein cholesterol concentration was 2.3 mmol/L. The microvascular disease odds ratio increased by a factor of 1.16 (95% confidence interval, 1.11-1.22) for every 0.5 mmol/L (approximate to 1 quintile) increase in triglycerides or decreased by a factor of 0.92 (0.88-0.96) for every 0.2 mmol/L (approximate to 1 quintile) increase in high-density lipoprotein cholesterol. For kidney disease, the odds ratio increased by 1.23 (1.16-1.31) with triglycerides and decreased by 0.86 (0.82-0.91) with high-density lipoprotein cholesterol. Retinopathy was associated with triglycerides and high-density lipoprotein cholesterol in matched analysis but not significantly after additional adjustment. Conclusions Diabetic kidney disease is associated worldwide with higher levels of plasma triglycerides and lower levels of high-density lipoprotein cholesterol among patients with good control of low-density lipoprotein cholesterol. Retinopathy was less robustly associated with these lipids. These results strengthen the rationale for studying dyslipidemia treatment to prevent diabetic microvascular disease.
引用
收藏
页码:999 / 1008
页数:10
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