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Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort
AIMS/INTRODUCTION: Diabetic kidney disease (DKD) exacerbates dyslipidemia and increases the incidence of atherosclerotic cardiovascular disease. DKD is a concept that includes typical diabetic nephropathy and an atypical phenotype without proteinuria. We investigated dyslipidemia in different DKD ph...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017612/ https://www.ncbi.nlm.nih.gov/pubmed/34665936 http://dx.doi.org/10.1111/jdi.13697 |
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author | Hirano, Tsutomu Satoh, Noriyuki Kodera, Rieko Hirashima, Takeshi Suzuki, Natsuko Aoki, Ema Oshima, Taito Hosoya, Mitsuru Fujita, Masahiro Hayashi, Toshiyuki Ito, Yasuki |
author_facet | Hirano, Tsutomu Satoh, Noriyuki Kodera, Rieko Hirashima, Takeshi Suzuki, Natsuko Aoki, Ema Oshima, Taito Hosoya, Mitsuru Fujita, Masahiro Hayashi, Toshiyuki Ito, Yasuki |
author_sort | Hirano, Tsutomu |
collection | PubMed |
description | AIMS/INTRODUCTION: Diabetic kidney disease (DKD) exacerbates dyslipidemia and increases the incidence of atherosclerotic cardiovascular disease. DKD is a concept that includes typical diabetic nephropathy and an atypical phenotype without proteinuria. We investigated dyslipidemia in different DKD phenotypes that have not been fully studied. MATERIALS AND METHODS: Fasting plasma was obtained from 1,073 diabetes patients enrolled in the regional diabetes cohort (ViNA cohort). Non‐proteinuric and proteinuric DKD were defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2) in the absence or presence of urinary albumin‐to‐creatinine ratio >300 mg/g. Novel lipid risk factors, low‐density lipoprotein (LDL) triglyceride (TG) and small dense LDL cholesterol were measured using our established homologous assay. RESULTS: The proportion of atherosclerotic cardiovascular disease patients was higher in non‐proteinuric DKD and even higher in proteinuric DKD than in non‐DKD. Increased estimated glomerular filtration rate grade and albuminuric stage were independently correlated with higher TG, TG‐rich lipoprotein cholesterol and apolipoprotein CIII. Therefore, proteinuric DKD had the highest of these levels. Small dense LDL cholesterol and LDL‐TG were higher in the proteinuria without renal dysfunction group in the lipid‐lowering drug‐free subset. Lipoprotein(a) was higher in DKD regardless of proteinuria. CONCLUSIONS: Proteinuria was associated with an atherogenic subspecies of LDL, whereas renal dysfunction was associated with increased lipoprotein(a). Proteinuria and renal dysfunction independently exacerbated TG‐rich lipoprotein‐related dyslipidemia. This is in good agreement with the results of large‐scale clinical studies in which proteinuria and renal dysfunction synergistically increased the risk of atherosclerotic cardiovascular disease in populations with diabetes. |
format | Online Article Text |
id | pubmed-9017612 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90176122022-04-21 Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort Hirano, Tsutomu Satoh, Noriyuki Kodera, Rieko Hirashima, Takeshi Suzuki, Natsuko Aoki, Ema Oshima, Taito Hosoya, Mitsuru Fujita, Masahiro Hayashi, Toshiyuki Ito, Yasuki J Diabetes Investig Original Articles AIMS/INTRODUCTION: Diabetic kidney disease (DKD) exacerbates dyslipidemia and increases the incidence of atherosclerotic cardiovascular disease. DKD is a concept that includes typical diabetic nephropathy and an atypical phenotype without proteinuria. We investigated dyslipidemia in different DKD phenotypes that have not been fully studied. MATERIALS AND METHODS: Fasting plasma was obtained from 1,073 diabetes patients enrolled in the regional diabetes cohort (ViNA cohort). Non‐proteinuric and proteinuric DKD were defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2) in the absence or presence of urinary albumin‐to‐creatinine ratio >300 mg/g. Novel lipid risk factors, low‐density lipoprotein (LDL) triglyceride (TG) and small dense LDL cholesterol were measured using our established homologous assay. RESULTS: The proportion of atherosclerotic cardiovascular disease patients was higher in non‐proteinuric DKD and even higher in proteinuric DKD than in non‐DKD. Increased estimated glomerular filtration rate grade and albuminuric stage were independently correlated with higher TG, TG‐rich lipoprotein cholesterol and apolipoprotein CIII. Therefore, proteinuric DKD had the highest of these levels. Small dense LDL cholesterol and LDL‐TG were higher in the proteinuria without renal dysfunction group in the lipid‐lowering drug‐free subset. Lipoprotein(a) was higher in DKD regardless of proteinuria. CONCLUSIONS: Proteinuria was associated with an atherogenic subspecies of LDL, whereas renal dysfunction was associated with increased lipoprotein(a). Proteinuria and renal dysfunction independently exacerbated TG‐rich lipoprotein‐related dyslipidemia. This is in good agreement with the results of large‐scale clinical studies in which proteinuria and renal dysfunction synergistically increased the risk of atherosclerotic cardiovascular disease in populations with diabetes. John Wiley and Sons Inc. 2021-11-02 2022-04 /pmc/articles/PMC9017612/ /pubmed/34665936 http://dx.doi.org/10.1111/jdi.13697 Text en © 2021 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Hirano, Tsutomu Satoh, Noriyuki Kodera, Rieko Hirashima, Takeshi Suzuki, Natsuko Aoki, Ema Oshima, Taito Hosoya, Mitsuru Fujita, Masahiro Hayashi, Toshiyuki Ito, Yasuki Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort |
title | Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort |
title_full | Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort |
title_fullStr | Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort |
title_full_unstemmed | Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort |
title_short | Dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: A cross‐sectional study from a regional diabetes cohort |
title_sort | dyslipidemia in diabetic kidney disease classified by proteinuria and renal dysfunction: a cross‐sectional study from a regional diabetes cohort |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017612/ https://www.ncbi.nlm.nih.gov/pubmed/34665936 http://dx.doi.org/10.1111/jdi.13697 |
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