Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: The FinnDiane study

N. Tolonen; K. Hietala; C. Forsblom; V. Harjutsalo; V. P. Mäkinen; J. Kytö; P. A. Summanen; L. M. Thorn; J. Wadén; D. Gordin; M. R. Taskinen; P. H. Groop

doi:10.1111/joim.12111

Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: The FinnDiane study

N. Tolonen, K. Hietala, C. Forsblom, V. Harjutsalo, V. P. Mäkinen, J. Kytö, P. A. Summanen, L. M. Thorn, J. Wadén, D. Gordin, M. R. Taskinen, P. H. Groop

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Abstract

Objectives: The aim of this study was to investigate the associations between lipid profiles and retinopathy in the large nationwide FinnDiane Study and to examine interactions and correlations between retinopathy, nephropathy and lipid variables. Design and subjects: A total of 1465 patients with type 1 diabetes, available lipid profiles, ophthalmic records and fundus photographs were included in the study. The Early Treatment of Diabetic Retinopathy Study scale was used to assess the severity of retinopathy. In an independent cohort of 1100 patients, laser treatment was used to define severe diabetic retinopathy. Results: HDL cholesterol was associated with proliferative retinopathy (PDR), and triglycerides were associated with mild nonproliferative retinopathy (NPDR) independently of nephropathy and other conventional risk factors (P < 0.01). Significant interactions were seen between albumin excretion rate (AER), retinopathy status and lipid parameters (including triglycerides, non-HDL cholesterol and apolipoprotein B; P < 0.001). Highly different correlations between AER and lipid variables were observed in patients without retinopathy or with mild NPDR compared with patients with moderate to severe NPDR or PDR. Similar interactions and correlations were observed in an independent cohort stratified by laser treatment. In patients without retinopathy or with mild NPDR, AER was low despite HDL cholesterol in the lowest or triglycerides, total cholesterol or LDL cholesterol in the highest quartiles. Conclusions: Nephropathy had a strong effect on the associations between lipid variables and retinopathy, whilst dyslipidaemia was associated with nephropathy only in the presence of retinopathy. This finding suggests the existence of shared pathogenic mechanisms between retinopathy and nephropathy which could be targeted to prevent complications in patients with metabolic risk factors.

Original language	English
Pages (from-to)	469-479
Number of pages	11
Journal	Journal of Internal Medicine
Volume	274
Issue number	5
DOIs	https://doi.org/10.1111/joim.12111
Publication status	Published or Issued - Nov 2013
Externally published	Yes

Keywords

Apolipoproteins
Diabetic nephropathy
Lipids
Lipoproteins
Type 1 diabetes

ASJC Scopus subject areas

Internal Medicine

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10.1111/joim.12111

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Tolonen, N., Hietala, K., Forsblom, C., Harjutsalo, V., Mäkinen, V. P., Kytö, J., Summanen, P. A., Thorn, L. M., Wadén, J., Gordin, D., Taskinen, M. R., & Groop, P. H. (2013). Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: The FinnDiane study. Journal of Internal Medicine, 274(5), 469-479. https://doi.org/10.1111/joim.12111

@article{baf22b229e604ca0a9113cea36b90cb7,

title = "Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: The FinnDiane study",

abstract = "Objectives: The aim of this study was to investigate the associations between lipid profiles and retinopathy in the large nationwide FinnDiane Study and to examine interactions and correlations between retinopathy, nephropathy and lipid variables. Design and subjects: A total of 1465 patients with type 1 diabetes, available lipid profiles, ophthalmic records and fundus photographs were included in the study. The Early Treatment of Diabetic Retinopathy Study scale was used to assess the severity of retinopathy. In an independent cohort of 1100 patients, laser treatment was used to define severe diabetic retinopathy. Results: HDL cholesterol was associated with proliferative retinopathy (PDR), and triglycerides were associated with mild nonproliferative retinopathy (NPDR) independently of nephropathy and other conventional risk factors (P < 0.01). Significant interactions were seen between albumin excretion rate (AER), retinopathy status and lipid parameters (including triglycerides, non-HDL cholesterol and apolipoprotein B; P < 0.001). Highly different correlations between AER and lipid variables were observed in patients without retinopathy or with mild NPDR compared with patients with moderate to severe NPDR or PDR. Similar interactions and correlations were observed in an independent cohort stratified by laser treatment. In patients without retinopathy or with mild NPDR, AER was low despite HDL cholesterol in the lowest or triglycerides, total cholesterol or LDL cholesterol in the highest quartiles. Conclusions: Nephropathy had a strong effect on the associations between lipid variables and retinopathy, whilst dyslipidaemia was associated with nephropathy only in the presence of retinopathy. This finding suggests the existence of shared pathogenic mechanisms between retinopathy and nephropathy which could be targeted to prevent complications in patients with metabolic risk factors.",

keywords = "Apolipoproteins, Diabetic nephropathy, Lipids, Lipoproteins, Type 1 diabetes",

author = "N. Tolonen and K. Hietala and C. Forsblom and V. Harjutsalo and M{\"a}kinen, {V. P.} and J. Kyt{\"o} and Summanen, {P. A.} and Thorn, {L. M.} and J. Wad{\'e}n and D. Gordin and Taskinen, {M. R.} and Groop, {P. H.}",

year = "2013",

month = nov,

doi = "10.1111/joim.12111",

language = "English",

volume = "274",

pages = "469--479",

journal = "Journal of Internal Medicine",

issn = "0954-6820",

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Tolonen, N, Hietala, K, Forsblom, C, Harjutsalo, V, Mäkinen, VP, Kytö, J, Summanen, PA, Thorn, LM, Wadén, J, Gordin, D, Taskinen, MR & Groop, PH 2013, 'Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: The FinnDiane study', Journal of Internal Medicine, vol. 274, no. 5, pp. 469-479. https://doi.org/10.1111/joim.12111

TY - JOUR

T1 - Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes

T2 - The FinnDiane study

AU - Tolonen, N.

AU - Hietala, K.

AU - Forsblom, C.

AU - Harjutsalo, V.

AU - Mäkinen, V. P.

AU - Kytö, J.

AU - Summanen, P. A.

AU - Thorn, L. M.

AU - Wadén, J.

AU - Gordin, D.

AU - Taskinen, M. R.

AU - Groop, P. H.

PY - 2013/11

Y1 - 2013/11

N2 - Objectives: The aim of this study was to investigate the associations between lipid profiles and retinopathy in the large nationwide FinnDiane Study and to examine interactions and correlations between retinopathy, nephropathy and lipid variables. Design and subjects: A total of 1465 patients with type 1 diabetes, available lipid profiles, ophthalmic records and fundus photographs were included in the study. The Early Treatment of Diabetic Retinopathy Study scale was used to assess the severity of retinopathy. In an independent cohort of 1100 patients, laser treatment was used to define severe diabetic retinopathy. Results: HDL cholesterol was associated with proliferative retinopathy (PDR), and triglycerides were associated with mild nonproliferative retinopathy (NPDR) independently of nephropathy and other conventional risk factors (P < 0.01). Significant interactions were seen between albumin excretion rate (AER), retinopathy status and lipid parameters (including triglycerides, non-HDL cholesterol and apolipoprotein B; P < 0.001). Highly different correlations between AER and lipid variables were observed in patients without retinopathy or with mild NPDR compared with patients with moderate to severe NPDR or PDR. Similar interactions and correlations were observed in an independent cohort stratified by laser treatment. In patients without retinopathy or with mild NPDR, AER was low despite HDL cholesterol in the lowest or triglycerides, total cholesterol or LDL cholesterol in the highest quartiles. Conclusions: Nephropathy had a strong effect on the associations between lipid variables and retinopathy, whilst dyslipidaemia was associated with nephropathy only in the presence of retinopathy. This finding suggests the existence of shared pathogenic mechanisms between retinopathy and nephropathy which could be targeted to prevent complications in patients with metabolic risk factors.

AB - Objectives: The aim of this study was to investigate the associations between lipid profiles and retinopathy in the large nationwide FinnDiane Study and to examine interactions and correlations between retinopathy, nephropathy and lipid variables. Design and subjects: A total of 1465 patients with type 1 diabetes, available lipid profiles, ophthalmic records and fundus photographs were included in the study. The Early Treatment of Diabetic Retinopathy Study scale was used to assess the severity of retinopathy. In an independent cohort of 1100 patients, laser treatment was used to define severe diabetic retinopathy. Results: HDL cholesterol was associated with proliferative retinopathy (PDR), and triglycerides were associated with mild nonproliferative retinopathy (NPDR) independently of nephropathy and other conventional risk factors (P < 0.01). Significant interactions were seen between albumin excretion rate (AER), retinopathy status and lipid parameters (including triglycerides, non-HDL cholesterol and apolipoprotein B; P < 0.001). Highly different correlations between AER and lipid variables were observed in patients without retinopathy or with mild NPDR compared with patients with moderate to severe NPDR or PDR. Similar interactions and correlations were observed in an independent cohort stratified by laser treatment. In patients without retinopathy or with mild NPDR, AER was low despite HDL cholesterol in the lowest or triglycerides, total cholesterol or LDL cholesterol in the highest quartiles. Conclusions: Nephropathy had a strong effect on the associations between lipid variables and retinopathy, whilst dyslipidaemia was associated with nephropathy only in the presence of retinopathy. This finding suggests the existence of shared pathogenic mechanisms between retinopathy and nephropathy which could be targeted to prevent complications in patients with metabolic risk factors.

KW - Apolipoproteins

KW - Diabetic nephropathy

KW - Lipids

KW - Lipoproteins

KW - Type 1 diabetes

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U2 - 10.1111/joim.12111

DO - 10.1111/joim.12111

M3 - Article

C2 - 23844944

AN - SCOPUS:84885839549

SN - 0954-6820

VL - 274

SP - 469

EP - 479

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

IS - 5

ER -

Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: The FinnDiane study

Abstract

Keywords

ASJC Scopus subject areas

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