[Preliminary analysis of the relationship between peripheral arterial disease and other atherosclerosis markers and diabetic nephropathy].
OBJECTIVE
To determine lipid serum levels, lipoproteins and other markers related to nephropathy and peripheral arterial disease (PAD) in a type 2 diabetes population stratified according to their level of renal dysfunction.


METHODS
A cross-sectional study was conducted on 72 type 2 diabetic patients followed-up in outpatient clinics. Patients were divided into 4 groups according to their estimated glomerular filtration rate (eGFR, mL/min) and albumin/creatinine ratio (ACR, mg/g) (eGFR > 60 and ACR < 30 [n = 23], eGFR > 60 and ACR > 30 [n = 12], eGFR30-60 [n = 23] and eGFR < 30 [n = 14]). Clinical and anthropometric characteristic of all patients were recorded. Fasting lipids and apolipoproteins, as well as renal and hematology parameters were measured. Finally, a multivariate Wald stepwise logistic regression statistic analysis was performed to determine variables independently associated with the presence of renal dysfunction.


RESULTS
The univariate statistical analysis showed that the higher renal dysfunction, the higher the prevalence of hypertension, smoking habit and triglycerides levels, and the lower hemoglobin levels (P < .05). The multivariate statistical analysis showed that only triglycerides levels (OR: 1.019, 95% CI: 1.004-1.034) and hemoglobin levels (OR: 0.516 95% CI: 0.292-0.914) were independently associated to the presence of renal dysfunction (eGFR < 60 mL/min.). The further inclusion of the presence of PAD in the statistical model did not modify those associations.


CONCLUSIONS
The results confirm the relationship between triglycerides levels and diabetic nephropathy, independently of the presence of PAD.
Laboratorio de Lípidos y Arteriosclerosis (CIMES), Departamento de Medicina y Dermatología, Facultad de Medicina, Universidad de Málaga, Málaga, España. Electronic address: jose.rioja@uma.es.
José
J
Rioja
Unidad de Gestión Clínica de Medicina Interna, Hospital Universitario Virgen de la Victoria e Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Málaga, España.
Tamara
T
Moreno
Servicio de Medicina Interna, Hospital de Puertollano, Ciudad Real, España.
Inmaculada
I
Coca
Unidad de Gestión Clínica de Urología y Nefrología, Hospital Virgen de la Victoria, Málaga, España.
Manuel
M
Jiménez-Villodres
Unidad de Gestión Clínica de Angiología y Cirugía Vascular, Hospital Universitario Virgen de la Victoria, Málaga, España.
Alejandro
A
Rodríguez-Morata
Unidad de Gestión Clínica de Medicina Interna, Hospital Universitario Virgen de la Victoria e Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Málaga, España.
Pedro
P
Valdivielso
D000368:Aged; D050197:Atherosclerosis / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000503:physiopathology*; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D006454:Hemoglobins; D008055:Lipids; D014280:Triglycerides
Diabetic nephropathy; Enfermedad arterial periférica; Nefropatía diabética; Peripheral arterial disease; Triglicéridos; Triglycerides