Total and LDL cholesterol are associated with glomerular filtration rate in normoalbuminuric type 1 diabetic patients [Ukupni i LDL kolesterol su povezani s glomerularnom flitracijom u normoalbuminuričnih bolesnika sa tipom 1 šećerne bolesti]

Bulum, Tomislav and Kolarić, Branko and Prkačin, Ingrid and Duvnjak, Lea (2013) Total and LDL cholesterol are associated with glomerular filtration rate in normoalbuminuric type 1 diabetic patients [Ukupni i LDL kolesterol su povezani s glomerularnom flitracijom u normoalbuminuričnih bolesnika sa tipom 1 šećerne bolesti]. Collegium Antropologicum, 37 (3). pp. 771-776. ISSN 0350-6134

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Abstract

Studies have generally suggested a positive association between dyslipidemia and chronic kidney disease, but sparse data are available on the relation of lipids and glomerular filtration rate in patients with normal renal function. We investigated the associations of serum lipids, including total, LDL, HDL, VLDL cholesterol, and triglyceride levels with estimated glomerular filtration rate (eGFR) in type 1 diabetic patients. Study included 313 normoalbuminuric type 1 diabetic patients with normal or mild decrease (eGFR > 60 mL/min per 1.73 m2) renal function and before any interventions with statins, ACE inhibitors or angiotensin II receptor blockers. eGFR was significantly associated with total, LDL, and HDL cholesterol (r = -0.21, -0.18, and -0.17, respectively, for all p < 0.05). Stratifying serum lipids for degree of eGFR, levels of total, LDL, and HDL cholesterol were inversely related to eGFR, but trends were significant only for total (5.1 vs 5.0 and 4.6 mmol/L) and LDL cholesterol (2.9 vs 2.8 and 2.4 mmol/L). We have detected an association between eGFR and lipid abnormalities in type 1 diabetes in early stages. The study was conducted in patients with no therapeutic intervention. This may suggest that lipid abnormalities may play a role in the pathogenesis of renal impairment in type 1 diabetic patients.

Abstract in Croatian

Mnoga istraživanja su potvrdila značaj dislipidemije u kroničnoj bubrežnoj bolesti, ali malo toga je poznato o utjecaju serumskih lipida na glomerularnu filtraciju u osoba sa normalnom bubrežnom funkcijom. Istraživali smo povezanost serumskih lipida (ukupnog, LDL, HDL, HDL2, HDL3, VLDL kolesterola i triglicerida) te glomerularne filtracije (GF) u bolesnika sa tipom 1 šećerne bolesti. Istraživanje je obuhvatilo 313 normoalbuminuričnih bolesnika sa tipom 1 šećerne bolesti s urednom ili blago sniženom bubrežnom funkcijom (GF >60 mL/min/ 1.73 m2) i prije terapije statinima, ACE-inhibitorima ili blokatorima angiotenzinskih receptora. GF procijenjena CKD-EPI iMDRD formulom bila je statistički značajno povezana s ukupnim, LDL, HDL, HDL2, i HDL3 kolesterolom (r= –0.21, –0.18, –0.17, –0.21, i –0.14, za sve p<0.05). Nakon podjele bolesnika prema stupnju GF, razina ukupnog, LDL, HDL i HDL2 kolesterola je bila u negativnoj povezanosti s razinom GF, ali je statistički značajna povezanost dokazana samo za razinu ukupnog (5.1 prema 5.0 i 4.6 mmol/L) i LDL kolesterola (2.9 prema 2.8 i 2.4 mmol/L). Rezultati istraživanja ukazuju da je lipidni poremećaj prisutan već u stanju normalne bubrežne funkcije u normoalbuminuričnih bolesnika sa tipom 1 šećerne bolesti i da je viša razina ukupnog i LDL kolesterola povezana s pogoršanjem GF. Prospektivne studije će pokazati da li navedeni lipidni poremećaji doprinose progresiji bubrežne bolesti u bolesnika sa tipom 1 šećerne bolesti.

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