Clinical Correlation between ApoB/ApoA1 Ratio in Type 2 Diabetic Nephropathy-A Tertiary Centre Experience (original) (raw)
Related papers
Kidney International, 2005
Lipid abnormalities associated with urinary albumin excretion rate in Taiwanese type 2 diabetic patients. Background. The purpose of this study was to examine the lipid abnormalities associated with urinary albumin excretion rate (UAER) in type 2 diabetic patients. Methods. A total of 275 (122 men and 153 women; aged 60.6 ± 11.1 years) patients were selected with stringent criteria to prevent confounders. Normoalbuminuria (N = 152) and albuminuria (N = 123) were defined as urinary albumin-to-creatinine ratio (ACR) of <30 and ≥30 lg/mg, respectively. Total cholesterol, triglycerides, low-density lipoprotein (LDL) and highdensity lipoprotein (HDL) cholesterol, and apolipoproteins A1 (ApoA1) and B (ApoB) were measured and non-HDL cholesterol calculated. The subjects were divided into four phenotypes based on triglycerides (<1.5 or ≥1.5 mmol/L) and ApoB (<1.2 or ≥1.2 g/L). Results. Total cholesterol, ApoB, and non-HDL cholesterol were significantly (P < 0.05) higher in patients with albuminuria. For quartiles of the lipid parameters, prevalences of albuminuria showed significant association with ApoB and non-HDL cholesterol (P trend <0.05). After adjusting for age, systolic blood pressure and hemoglobin A 1c (HbA 1c) correlation coefficients between the natural logarithm (ln) ACR and lipid parameters, odds ratios for albuminuria, and standardized regression coefficients for ln ACR, were significant for total cholesterol, ApoB and non-HDL cholesterol in all subjects and in men, but only ApoB was significant in women. For patients with normoalbuminuria, frequencies of normotriglycerides/ normo-ApoB, hypertriglycerides/normo-ApoB, normotriglycerides/hyper-ApoB, and hypertriglycerides/hyper-ApoB were 44.7%, 28.9%, 10.5%, and 15.8%, respectively; and were 30.1%, 19.5%, 15.4%, and 35.0% for patients with albuminuria (P < 0.001). The respective adjusted odds ratio for albuminuria for the four phenotypes was 1.00, 1.04 (0.54 to 2.00), 2.25 (1.02 to 5.00), and 3.38 (1.75 to 6.53). Conclusion. Increased UAER is associated with ApoBcontaining lipoproteins and the phenotype of hypertriglycerides/hyper-ApoB is associated with the highest risk of
High triglyceride-to-HDL cholesterol ratio associated with albuminuria in type 2 diabetic subjects
Journal of Diabetes and its Complications, 2013
Objective: Emerging evidence indicates that metabolic syndrome (MetS) predisposes diabetic subjects to nephropathy. Aside from hypertension and hyperglycemia, it is unclear which component of MetS also contributes to increased urinary albumin excretion (UAE). We compared the MetS profiles of subjects divided into two groups based on their UAE. Methods: The Asia Pacific Real-Life Effectiveness and Care Patterns of Diabetes Management (AP RECAP-DM) study is a cross-sectional survey in which type 2 diabetic subjects using oral anti-hyperglycemic drugs were enrolled. We analyzed the data of 162 type 2 diabetic subjects with normotension or taking antihypertensive medications. Results: There were 123 subjects with normal UAE (b 30 mg/g) and 39 with abnormal UAE (≥ 30 mg/g). MetS was more prevalent in the abnormal UAE group (79.5%) than in the normal UAE group (58.5%) (P = 0.018). Hypertriglyceridemia (odds ratio = 8.65, P b 0.001) and reduced high-density lipoprotein (HDL) cholesterol (odds ratio = 3.27, P = 0.022) were both independently associated with abnormal UAE. Using 3.4 as a cutoff value, a high triglyceride-to-HDL cholesterol ratio was a useful marker (odds ratio = 15.05, P b 0.001) for abnormal UAE. Conclusions: A high triglyceride-to-HDL cholesterol ratio was found to be an important risk factor for nephropathy in type 2 diabetic subjects.
Extended lipid profile and urine albumin-creatinine ratio in type 2 diabetes mellitus
GSC Biological and Pharmaceutical Sciences
Background: Diabetes is a chronic metabolic disorder and has become the one of the most challenging global health problem of 21 st centuary. Diabetic nephropathy is a major complication of diabetes and an established risk factor for cardiovascular events. Lipid abnormalities occur in patients with diabetic nephropathy, which further increase their risk for cardiovascular events. We aimed to research association between extended lipid profile and urine albumin-creatinine ratio (UACR), hypothesizing that early detection and treatment of lipid abnormalities can minimize the risk for atherogenic cardiovascular disorder and cerebrovascular accident in patients with type 2 diabetes mellitus. Methods: A hospital based cross- sectional study was conducted on 48 patients with type 2 diabetes mellitus. All patients fasting blood glucose (FBG), HbA1c, total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), apolipoprotein-A (apo-A), apolipoprote...
Lipid abnormalities in insulin-dependent diabetic patients with albuminuria
Diabetes Care, 1984
The relationship between serum lipid, lipoprotein, and apolipoprotein levels and abnormalities of renal function has been investigated in 112 insulin-dependent (type I) diabetic patients. They were subdivided into three matched groups according to the amount of albuminuria: group A (albuminuria < 20 μg/min), group B (albuminuria between 20 and 150 μg/min; Albustix negative), and group C (albuminuria > 150 μg/min; Albustix positive). Twenty-one nondiabetic subjects with albuminuria above 150 μg/min but without nephrotic syndrome and/or renal failure and 77 healthy subjects were also studied. Mean total and LDL cholesterol, triglycerides, and apo B were higher, while HDL cholesterol and HDL/LDLcholesterol ratio were lower in group C than in groups A and B; the apo A/apo B ratio was lower in group C than in group A. Differences in apo B and in apo A/apo B ratio were found between groups A and B. No correlation between lipid parameters and amount of albuminuria was observed. Signi...
Lipid profile in Type 2 diabetes mellitus and in diabetic nephropathy
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Diabetes mellitus (DM) is characterized by abnormalities of carbohydrate, protein and fat metabolism due to absolute or relative deficiency of insulin secretion, accompanied by varying degrees of resistance to insulin. Diabetes mellitus is currently the most common etiology for chronic kidney disease (CKD). Abnormalities of lipoprotein metabolism is associated with Diabetic nephropathy(DN), which can be influenced by derangement of renal function and the degree of metabolic control in diabetes mellitus. Our objective is to compare the levels of lipid profile, urine microalbumin and glycated haemoglobin (HbA1c) between type 2 Diabetes mellitus (T2DM) without any complications, T2DM with nephropathy and normal controls who were age and sex matched. Materials and Method: Study group consisted of 75 individuals of whom 25 were T2DM without any complications, 25 were T2DM with nephropathy and 25 were healthy controls. Total cholesterol (TC), Triglycerides(TG), LDL Cholesterol(LDL-c), HDL Chlolesterol (HDL-c), HbA1c and urine microalbumin were measured in these subjects. Results: The values of TC, TG, LDL-c, HbA1c and urine microalbumin levels were significantly higher in T2DM without any complications and T2DM with nephropathy when compared to controls. HDL-c level was significantly lower in T2DM without any complications and T2DM with nephropathy when compared to controls. Conclusions: T2DM and DN are associated with dyslipidemia which is more pronounced in diabetic nephropathy. Therefore, early detection of dyslipidemia in Type 2 diabetics and accordingly therapeutic intervention could control the resulting cardiovascular or renal complications.
https://www.ijrrjournal.com/IJRR\_Vol.7\_Issue.12\_Dec2020/Abstract\_IJRR0017.html, 2020
Objective: The main objective of the study was comparatively evaluation of serum lipid abnormalities in type 2 diabetes mellitus patients with or without diabetic nephropathy. Methods & materials: This is an observational study to explore the lipid abnormalities in diabetic patients with or without diabetic nephropathy. After taking patients consent demographic details like weight, height, age, weight were documented in a predesigned proforma and serological test was performed to identify , glycemic parameters like fasting blood glucose (FBG) , post prandial blood glucose (PPBG), glycated haemoglobin and serum lipid parameters like total cholesterol(TC), serum triglycerides (TG), Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). Results: It was observed that both with and without nephropathy group had almost similar age group which was 52.7±9.79 and 53.4±9.35 years respectively. Between two groups there was no statistically significant difference (p value=0.823) as per age is concern. There were significant statistical differences in glycemic parameters and serial lipid parameters in-between the two groups. With nephropathy group, 70% of T2DM patients and without nephropathy group 44% of T2DM patients had dyslipidemia. Atherogenic dyslipidemia was observed 7% in diabetes with nephropathy group and 11% in without nephropathy group. In nephropathy group there were a higher percentage of subjects with dyslipidemia (p value=0.02). Conclusion: In the management of diabetes an important therapeutic target identified as dyslipidemia. Abnormal lipoprotein metabolism accelerates diabetic nephropathy which causes cardiovascular disease as well as the progression of diabetic nephropathy.
2019
Introduction: Hyperglycemia induced oxidative stress in Type 2 Diabetes Mellitus modify various biomolecules to cause Diabetic Nephropathy (DN). IMA (Ischemia-Modified Albumin) is one such oxidative stress marker already examined in various clinical events but have not yet been evaluated in different stages of DN. Aim: To estimate and assess the relationship of IMA with glycemic status and lipid parameters in all stages of DN. Study Design: Cross-sectional study. Place and Duration of Study: Study was conducted at Department of Biochemistry, Kasturba Medical College Hospitals, Mangaluru conducted between 2014 and 2015. Original Research Article Ahmad et al.; IJBCRR, 27(2): 1-9, 2019; Article no.IJBCRR.51340 2 Materials and Methods: There were 60 type 2 diabetic cases and 30 healthy controls. Diabetic cases were further categorized into three equal groups on the basis of UACR (urine albumin-creatinine ratio), DN stage I having UACR less than 30 mg/g, DN stage II having UACR 30 to 300 mg/g, and DN stage III having UACR ≥ 300 mg/g of creatinine. Using enzyme-linked immunosorbent assay serum IMA level was estimated whereas automated analyzers was used for serum creatinine, HbA1c, urine albumin and urine creatinine analysis. Results: Lowest level of IMA (109 ng/mL) measured in DN stage I, which was significantly different from those in DN stage II (154 ng/mL) and DN stage III (178 ng/mL). The significant positive correlation between IMA and fasting blood glucose, glycated hemoglobin were present in stage II and stage III DN. In this study significant positive correlation of serum IMA to serum total cholesterol, low density lipoprotein cholesterol and negative correlation with high density lipoprotein were revealed in all stage of DN. Conclusion: Current study postulates that early evaluation of serum IMA in diabetic patients with deranged lipid profile will provide an index of nephropathy development. This will help in prognosis and controlling complication in diabetes mellitus.
Nephrology Dialysis Transplantation, 1998
Background. Chronic hyperglycaemia stands with diabetes duration as the main predicting factor for the development of nephropathy in insulin dependent diabetes mellitus (IDDM). In contrast, nephropathy in non-insulin-dependent diabetes mellitus (NIDDM) presents with a different natural history and, as well as atherosclerosis, can precede diabetes diagnosis and even the onset of patent hyperglycaemia. The role of lipid abnormalities in this matter remains debated. Methods. We studied the prevalence of nephropathy (N + = urinary albumin excretion rate (UAE) >20 rug/d) in 134 Caucasian NIDDM patients ranked according to alipoprotein E (apoE) genotype (same distribution in 132controls). Age, diabetes duration and sex ratio did not differ between N + and N-. A patient with E2E4 (n = 1) was excluded from the analysis. Results. The prevalence of nephropathy was significantly reduced in E2 allele carriers (36%, 8/22) vs 69% (77/111) in E2 non-carriers (P<O.Ol). Relative risk (RR) of E2 carriers developing nephropathy was 0.52 (95% CI =0.35-0.80). Both groups were comparable in terms of age (55±11 vs 57±11 years), diabetes duration (15 ±9 vs 14± 10 years) and prevalence of retinopathy (59 vs 48%). Similar results were observed when patients with diabetes duration longer than 8 years were studied (n = 94). Conclusions. It has been largely established that lowdensity lipoprotein (LDL)-cholesterollevel in E2 allele carriers (whether diabetic or not) was lower than in E2 non-carriers. The 2-fold increase of nephropathy in E2 non-carriers with NIDDM argues for a role for LDL in the development of human nephropathy in NIDDM patients. This result is in agreement with previous data established both in vitro and in vivo in animal models. These findings support evidence for the pathogenic and morphologic similarities between kidney disease and atherosclerosis in NIDDM patients.
Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes
Diabetologia, 2009
Aims/hypothesis We studied the impact of baseline lipid variables on the progression of renal disease in a large nationwide prospective cohort of patients with type 1 diabetes. Methods A total of 2,304 adult patients with type 1 diabetes and available lipid profiles participating in the Finnish Diabetic Nephropathy Study (FinnDiane) were evaluated. Data on progression of renal disease were verified from medical files and patients were followed for 5.4±2.0 (mean ± SD) years. Results High triacylglycerol, apolipoprotein (Apo) B, ApoA-II and HDL 3 -cholesterol concentrations predicted incident microalbuminuria. Progression to macroalbuminuria was predicted by high triacylglycerol and ApoB. When AER was entered into the model, triacylglycerol was no longer an independent predictor, but when patients with normal AER and microalbuminuria at baseline were pooled, triacylglycerol, HbA 1c , male sex and AER were all independent predictors of renal disease. High total cholesterol, LDLcholesterol, non-HDL-cholesterol and triacylglycerol as well as low HDL-cholesterol, HDL 2 -cholesterol, ApoA-I and ApoA-II concentrations were predictive of progression to end-stage renal disease. However, when estimated GFR was entered into the model, only total cholesterol remained an independent predictor of progression. Conclusions/interpretation Lipid abnormalities, particularly high triacylglycerol concentrations, increase the risk of progression of renal disease.