Higher levels of HDL cholesterol are associated with a decreased likelihood of albuminuria in patients with long-standing standing type 1 diabetes

被引:39
作者
Molitch, ME
Rupp, D
Carnethon, M
机构
[1] Northwestern Univ, Div Endocrinol Metab & Mol Med, Feinberg Sch Med, Dept Med, Chicago, IL 60611 USA
[2] Northwestern Univ, Dept Prevent Med, Feinberg Sch Med, Chicago, IL 60611 USA
关键词
D O I
10.2337/diacare.29.01.06.dc05-1583
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - The objective of this study was to determine whether high levels of HDL cholesterol are associated with a lower prevalence of albuminuria. RESEARCH DESIGN AND METHODS - We analyzed the lipid profiles of patients with type I diabetes of >= 20 years duration in 42 patients With albuminuria (28 microalbuminuria and 14 macroalbuminuria) and 65 patients without increased albumin excretion before any interventions with either statins or ACE inhibitors. RESULTS - Several characteristics were similar in the two groups: sex, age, duration of diabetes, total cholesterol, LDL cholesterol, and triglycerides. By univariate analysis, significant differences (P < 0.01) were found in HDL cholesterol (albuminuria 1.42 mg/dl, no albuminuria 1.71 mg/dl, P < 0.01), HbA(1c) (AlC) (albuminuria 8.5%, no albuminuria 7.5%), and proportions with no, background, and proliferative retinopathy (albuminuria 2.4, 16.7, and 81%; no albuminuria 24.6, 52.3, and 23.1%, respectively). When adjusted for age and sex, a 0.26-mmol/l (10-mg/dl) increase in HDL cholesterol is associated with an odds ratio (OR) of 0.70 (95% CI 0.54-0.90) for having albuminuria. In a multivariate model that adjusted for age, sex, diabetes duration, and AlC, for every 0.54-mmol/l (21-mg/dl) increase in HDL cholesterol, patients are approximately half (OR 0.51 [95% CI 0.30-0.86]) as likely to have albuminuria, even after controlling or AlC. CONCLUSIONS - Higher HDL cholesterol levels may be protective against the development of albuminuria in patients with type I diabetes. Whether this is due to the HDL cholesterol levels or whether they serve as a marker for some other mechanism remains to be determined.
引用
收藏
页码:78 / 82
页数:5
相关论文
共 44 条
  • [31] Molitch ME, 1997, SEMIN NEPHROL, V17, P101
  • [32] *NAT CTR HLTH STAT, 2000, LDL CHOL 1999 2000 D
  • [33] Nephropathy in type I diabetes: A manifestation of insulin resistance and multiple genetic susceptibilities? Further evidence from the Pittsburgh Epidemiology of Diabetes Complication Study
    Orchard, TJ
    Chang, YF
    Ferrell, RE
    Petro, N
    Ellis, DE
    [J]. KIDNEY INTERNATIONAL, 2002, 62 (03) : 963 - 970
  • [34] Renoprotection in diabetes: genetic and non-genetic risk factors and treatment
    Parving, HH
    [J]. DIABETOLOGIA, 1998, 41 (07) : 745 - 759
  • [35] FAMILIAL CLUSTERING OF DIABETIC KIDNEY-DISEASE - EVIDENCE FOR GENETIC SUSCEPTIBILITY TO DIABETIC NEPHROPATHY
    SEAQUIST, ER
    GOETZ, FC
    RICH, S
    BARBOSA, J
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1989, 320 (18) : 1161 - 1165
  • [36] THE EFFECT OF INTENSIVE TREATMENT OF DIABETES ON THE DEVELOPMENT AND PROGRESSION OF LONG-TERM COMPLICATIONS IN INSULIN-DEPENDENT DIABETES-MELLITUS
    SHAMOON, H
    DUFFY, H
    FLEISCHER, N
    ENGEL, S
    SAENGER, P
    STRELZYN, M
    LITWAK, M
    WYLIEROSETT, J
    FARKASH, A
    GEIGER, D
    ENGEL, H
    FLEISCHMAN, J
    POMPI, D
    GINSBERG, N
    GLOVER, M
    BRISMAN, M
    WALKER, E
    THOMASHUNIS, A
    GONZALEZ, J
    GENUTH, S
    BROWN, E
    DAHMS, W
    PUGSLEY, P
    MAYER, L
    KERR, D
    LANDAU, B
    SINGERMAN, L
    RICE, T
    NOVAK, M
    SMITHBREWER, S
    MCCONNELL, J
    DROTAR, D
    WOODS, D
    KATIRGI, B
    LITVENE, M
    BROWN, C
    LUSK, M
    CAMPBELL, R
    LACKAYE, M
    RICHARDSON, M
    LEVY, B
    CHANG, S
    HEINHEINEMANN, M
    BARRON, S
    ASTOR, L
    LEBECK, D
    BRILLON, D
    DIAMOND, B
    VASILASDWOSKIN, A
    LAURENZI, B
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1993, 329 (14) : 977 - 986
  • [37] Increased small dense LDL and intermediate-density lipoprotein with albuminuria in type 1 diabetes
    Sibley, SD
    Hokanson, JE
    Steffes, MW
    Purnell, JQ
    Marcovina, SM
    Cleary, PA
    Brunzell, JD
    [J]. DIABETES CARE, 1999, 22 (07) : 1165 - 1170
  • [38] Differences in HDL-cholesterol:apoA-I plus apoA-II ratio and apoE phenotype with albuminuric status in Type I diabetic patients
    Soedamah-Muthu, SS
    Colhoun, HM
    Taskinen, MR
    Idzior-Walus, B
    Fuller, JH
    [J]. DIABETOLOGIA, 2000, 43 (11) : 1353 - 1359
  • [39] Steffes MW, 2003, JAMA-J AM MED ASSOC, V290, P2159, DOI 10.1001/jama.290.16.2159
  • [40] TREVISAN R, 1995, J LAB CLIN MED, V126, P342