José Rioja1, Tamara Moreno2, Inmaculada Coca3, Manuel Jiménez-Villodres4, Alejandro Rodríguez-Morata5, Pedro Valdivielso2. 1. 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. 2. 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. 3. Servicio de Medicina Interna, Hospital de Puertollano, Ciudad Real, España. 4. Unidad de Gestión Clínica de Urología y Nefrología, Hospital Virgen de la Victoria, Málaga, España. 5. Unidad de Gestión Clínica de Angiología y Cirugía Vascular, Hospital Universitario Virgen de la Victoria, Málaga, España.
Abstract
OBJECTIVES: 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. CONCLUSION: The results confirm the relationship between triglycerides levels and diabetic nephropathy, independently of the presence of PAD.
OBJECTIVES: 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 diabeticpatients 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. CONCLUSION: The results confirm the relationship between triglycerides levels and diabetic nephropathy, independently of the presence of PAD.