Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes.
OBJECTIVE
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, LDL-cholesterol, 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
Lipid abnormalities, particularly high triacylglycerol concentrations, increase the risk of progression of renal disease.
Tolonen
N
N
Folkhälsan Institute of Genetics, Folkhälsan Research Center, University of Helsinki, Biomedicum Helsinki (C318b), Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.
Forsblom
C
C
Thorn
L
L
Wadén
J
J
Rosengård-Bärlund
M
M
Saraheimo
M
M
Feodoroff
M
M
Mäkinen
V-P
VP
Gordin
D
D
Taskinen
M-R
MR
Groop
P-H
PH
D000328:Adult; D017668:Age of Onset; D016633:Apolipoprotein A-II / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D001794:Blood Pressure; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D003929:Diabetic Neuropathies / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D016633:Apolipoprotein A-II; D001055:Apolipoproteins B; D008055:Lipids; D014280:Triglycerides