In:
Diabetes Care, American Diabetes Association, Vol. 39, No. 12 ( 2016-12-01), p. 2278-2287
Abstract:
Despite the achievement of blood glucose, blood pressure, and LDL cholesterol (LDL-C) targets, the risk for diabetic kidney disease (DKD) remains high among patients with type 2 diabetes. This observational retrospective study investigated whether diabetic dyslipidemia—that is, high triglyceride (TG) and/or low HDL cholesterol (HDL-C) levels—contributes to this high residual risk for DKD. RESEARCH DESIGN AND METHODS Among a total of 47,177 patients attending Italian diabetes centers, 15,362 patients with a baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2, normoalbuminuria, and LDL-C ≤130 mg/dL completing a 4-year follow-up were analyzed. The primary outcome was the incidence of DKD, defined as either low eGFR ( & lt;60 mL/min/1.73 m2) or an eGFR reduction & gt;30% and/or albuminuria. RESULTS Overall, 12.8% developed low eGFR, 7.6% an eGFR reduction & gt;30%, 23.2% albuminuria, and 4% albuminuria and either eGFR & lt;60 mL/min/1.73 m2 or an eGFR reduction & gt;30%. TG ≥150 mg/dL increased the risk of low eGFR by 26%, of an eGFR reduction & gt;30% by 29%, of albuminuria by 19%, and of developing one abnormality by 35%. HDL-C & lt;40 mg/dL in men and & lt;50 mg/dL in women were associated with a 27% higher risk of low eGFR and a 28% risk of an eGFR reduction & gt;30%, with a 24% higher risk of developing albuminuria and a 44% risk of developing one abnormality. These associations remained significant when TG and HDL-C concentrations were examined as continuous variables and were only attenuated by multivariate adjustment for numerous confounders. CONCLUSIONS In a large population of outpatients with diabetes, low HDL-C and high TG levels were independent risk factors for the development of DKD over 4 years.
Type of Medium:
Online Resource
ISSN:
0149-5992
,
1935-5548
Language:
English
Publisher:
American Diabetes Association
Publication Date:
2016
detail.hit.zdb_id:
1490520-6
