Increased small dense LDL and intermediate-density lipoprotein with albuminuria in type 1 diabetes.
OBJECTIVE
This population study examines the relationship between LDL density and persistent albuminuria in subjects with type 1 diabetes at the end of the Diabetes Control and Complications Trial (DCCT).


METHODS
Subjects were classified as persistently normoalbuminuric (albumin excretion rate [AER] < 30 mg/d, n = 1,056), microalbuminuric (AER > or = 30-299 mg/day, n = 80), and macroalbuminuric (AER = 300 mg/day, n = 24) based on the last two AER measures.


RESULTS
Triglyceride (P < 0.01) and LDL cholesterol (P < 0.01) levels were higher in macroalbuminuric subjects compared with normoalbuminuric subjects. Cholesterol distribution by density-gradient ultracentrifugation showed an increase in intermediate-density lipoprotein (IDL) and a shift in peak LDL from buoyant toward more dense particles with progressive albuminuria. In the entire group, there was a significant negative correlation between the peak buoyancy of LDL particles and albuminuria (r = -0.238, P < 0.001, n = 1,160). This correlation persisted in the normoalbuminuric DCCT group (r = -0.138, P < 0.001, n = 1,056).


CONCLUSIONS
As albuminuria increases in subjects with type 1 diabetes, dyslipidemia occurs with an increase in IDL and dense LDL that may lead to increased cardiovascular disease.
Sibley
S D
SD
Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle 98195, USA. ssibley@u.washington.edu
Hokanson
J E
JE
Steffes
M W
MW
Purnell
J Q
JQ
Marcovina
S M
SM
Cleary
P A
PA
Brunzell
J D
JD
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000097:blood*; D015992:Body Mass Index; D008078:Cholesterol, LDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D053419:Lipoproteins, IDL; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D012016:Reference Values; D012044:Regression Analysis; D014280:Triglycerides / Q000097:blood
D008078:Cholesterol, LDL; D008074:Lipoproteins; D053419:Lipoproteins, IDL; D008077:Lipoproteins, LDL; D014280:Triglycerides