Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

N. Tolonen; C. Forsblom; L. Thorn; J. Wadén; M. Rosengård-Bärlund; M. Saraheimo; M. Feodoroff; V. P. Mäkinen; D. Gordin; M. R. Taskinen; P. H. Groop

doi:10.1007/s00125-009-1541-2

Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

N. Tolonen, C. Forsblom, L. Thorn, J. Wadén, M. Rosengård-Bärlund, M. Saraheimo, M. Feodoroff, V. P. Mäkinen, D. Gordin, M. R. Taskinen, P. H. Groop

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72 Citations (Scopus)

Abstract

Aims/hypothesis: 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 HDL₃-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, HDL₂-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/interpretation: Lipid abnormalities, particularly high triacylglycerol concentrations, increase the risk of progression of renal disease.

Original language	English
Pages (from-to)	2522-2530
Number of pages	9
Journal	Diabetologia
Volume	52
Issue number	12
DOIs	https://doi.org/10.1007/s00125-009-1541-2
Publication status	Published or Issued - Dec 2009
Externally published	Yes

Keywords

Albumin excretion rate
Albuminuria
Apolipoprotein
Cholesterol
Diabetic nephropathy
Estimated GFR
Lipid profile
Renal disease
Triacylglycerol
Type 1 diabetes

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism

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10.1007/s00125-009-1541-2

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@article{a0037493bda8450885401005a4d5302b,

title = "Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes",

abstract = "Aims/hypothesis: 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 HDL3-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, HbA1c, 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, HDL2-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/interpretation: Lipid abnormalities, particularly high triacylglycerol concentrations, increase the risk of progression of renal disease.",

keywords = "Albumin excretion rate, Albuminuria, Apolipoprotein, Cholesterol, Diabetic nephropathy, Estimated GFR, Lipid profile, Renal disease, Triacylglycerol, Type 1 diabetes",

author = "N. Tolonen and C. Forsblom and L. Thorn and J. Wad{\'e}n and M. Roseng{\aa}rd-B{\"a}rlund and M. Saraheimo and M. Feodoroff and M{\"a}kinen, {V. P.} and D. Gordin and Taskinen, {M. R.} and Groop, {P. H.}",

note = "Funding Information: Acknowledgements The study was supported by the Folkh{\"a}lsan Research Foundation, the Wilhelm and Else Stockmann Foundation, the Sigrid Juselius Foundation, the Liv och H{\"a}lsa Foundation, the Waldemar von Frenckell Foundation, the Finnish Medical Society and the European Commission (QLG2-CT-2001-01669). The skilled assistance of our laboratory technicians S. Lindh, A. Sandelin, H. Hilden, H. Perttunen-Mio, V. Naatti, S. Str{\"o}m and J. Thorn is gratefully acknowledged. Finally, we acknowledge physicians and nurses at each study centre (ESM).",

year = "2009",

month = dec,

doi = "10.1007/s00125-009-1541-2",

language = "English",

volume = "52",

pages = "2522--2530",

journal = "Diabetologia",

issn = "0012-186X",

publisher = "Springer Verlag",

number = "12",

}

TY - JOUR

T1 - Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

AU - Tolonen, N.

AU - Forsblom, C.

AU - Thorn, L.

AU - Wadén, J.

AU - Rosengård-Bärlund, M.

AU - Saraheimo, M.

AU - Feodoroff, M.

AU - Mäkinen, V. P.

AU - Gordin, D.

AU - Taskinen, M. R.

AU - Groop, P. H.

N1 - Funding Information: Acknowledgements The study was supported by the Folkhälsan Research Foundation, the Wilhelm and Else Stockmann Foundation, the Sigrid Juselius Foundation, the Liv och Hälsa Foundation, the Waldemar von Frenckell Foundation, the Finnish Medical Society and the European Commission (QLG2-CT-2001-01669). The skilled assistance of our laboratory technicians S. Lindh, A. Sandelin, H. Hilden, H. Perttunen-Mio, V. Naatti, S. Ström and J. Thorn is gratefully acknowledged. Finally, we acknowledge physicians and nurses at each study centre (ESM).

PY - 2009/12

Y1 - 2009/12

N2 - Aims/hypothesis: 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 HDL3-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, HbA1c, 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, HDL2-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/interpretation: Lipid abnormalities, particularly high triacylglycerol concentrations, increase the risk of progression of renal disease.

AB - Aims/hypothesis: 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 HDL3-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, HbA1c, 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, HDL2-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/interpretation: Lipid abnormalities, particularly high triacylglycerol concentrations, increase the risk of progression of renal disease.

KW - Albumin excretion rate

KW - Albuminuria

KW - Apolipoprotein

KW - Cholesterol

KW - Diabetic nephropathy

KW - Estimated GFR

KW - Lipid profile

KW - Renal disease

KW - Triacylglycerol

KW - Type 1 diabetes

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U2 - 10.1007/s00125-009-1541-2

DO - 10.1007/s00125-009-1541-2

M3 - Article

C2 - 19816673

AN - SCOPUS:70949093630

VL - 52

SP - 2522

EP - 2530

JO - Diabetologia

JF - Diabetologia

SN - 0012-186X

IS - 12

ER -

Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

Abstract

Keywords

ASJC Scopus subject areas

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