title: Kidney function, cholesterol absorption and remnant lipoprotein accumulation in patients with diabetes mellitus.
abstract: OBJECTIVE
  Remnant lipoproteins are atherogenic and increased in patients with type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD) and other conditions. Thus far, information is limited regarding the synthesis and absorption of cholesterol in CKD patients and a possible link to the remnant levels. We examined possible alterations in serum markers of cholesterol synthesis and absorption and their potential associations with remnant lipoproteins in patients with CKD.
  
  
  METHODS
  The subjects included 146 consecutive patients with T2DM in various stages of CKD. We measured the levels of remnant lipoprotein cholesterol (RemL-C), lathosterol (a cholesterol synthesis marker) and campesterol (a cholesterol absorption marker). The urinary albumin to creatinine ratio (U-ACR) and estimated glomerular filtration rate (eGFR) were used to describe the degree of CKD.
  
  
  RESULTS
  The median (interquartile range) levels of RemL-C, lathosterol and campesterol were 14.5 (11.5-23.4) mg/dL, 2.1 (1.7-2.9) μg/mL and 2.3 (1.7-3.0) μg/mL, respectively. The RemL-C level was positively correlated with the U-ACR and inversely correlated with the eGFR. The RemL-C level was positively correlated with both the lathosterol and campesterol levels. The lathosterol level was not significantly correlated with the U-ACR, although it was positively correlated with the eGFR. In contrast, the campesterol level was positively correlated with the ACR and inversely with the eGFR. In the multiple regression analysis, both lathosterol and campesterol were positively associated with the RemL-C level, independent of the U-ACR, eGFR and other variables.
  
  
  CONCLUSIONS
  The serum campesterol concentrations are higher in patients with a greater degree of albuminuria and a lower renal funtion. In this study, the markers of cholesterol absorption and synthesis were independent determinants of the RemL-C level. Increased intestinal cholesterol absorption may be an additional mechanism for remnant accumulation in T2DM patients with CKD.
authors: Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
authors: Mika
authors: M
authors: Sonoda
authors: Testuo
authors: T
authors: Shoji
authors: Eiji
authors: E
authors: Kimoto
authors: Yujiro
authors: Y
authors: Okute
authors: Hideaki
authors: H
authors: Shima
authors: Toshihide
authors: T
authors: Naganuma
authors: Koka
authors: K
authors: Motoyama
authors: Tomoaki
authors: T
authors: Morioka
authors: Katsuhito
authors: K
authors: Mori
authors: Shinya
authors: S
authors: Fukumoto
authors: Atsushi
authors: A
authors: Shioi
authors: Hidenori
authors: H
authors: Koyama
authors: Masanori
authors: M
authors: Emoto
authors: Masaaki
authors: M
authors: Inaba
mesh_terms: D000368:Aged; D002784:Cholesterol / Q000097:blood / Q000378:metabolism*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000502:physiology*; D008074:Lipoproteins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000378:metabolism
chemical_list: D008074:Lipoproteins; C030104:lipoprotein cholesterol; C001521:lathosterol; D002784:Cholesterol