Abstract
To explore how plasma levels of remnant lipoproteins are influenced by diabetic nephropathy, we measured intermediate-density lipoprotein (IDL, d=1.006-1.019) and remnant-like particle (RLP) cholesterol in type 2 diabetic patients with various degrees of kidney damage and 17 nondiabetic control subjects. Plasma triglyceride (TG) levels in diabetic patients without nephropathy were identical to those in nondiabetic controls, whereas these levels were significantly increased in diabetic patients with microalbuminuria, and were further increased in those with overt proteinuria and chronic renal failure. Plasma apoprotein (apo) B and total-cholesterol levels were increased in diabetic patients with microalbuminuria and overt proteinuria, but levels were decreased when accompanied with chronic renal failure. Similarly, concentrations of TG and cholesterol in IDL were substantially increased in diabetic patients with diabetic nephropathy including microalbuminuria. IDL-apo B levels were not increased in normoalbuminuric and microalbuminuric diabetic patients, but substantially increased in patients with overt proteinuria and with renal failure. RLP-cholesterol was significantly increased in patients with overt diabetic nephropathy.
There was no correlation between glycemic control and concentrations of remnant lipoproteins. These results suggest that diabetic nephropathy including microalbuminuria plays an important role in the accumulation of atherogenic remnant lipoproteins in diabetic patients, and that nephropathy is associtated with a high prevalence of atherosclerotic disease in these populations.
