Chronic renal failure in diabetic patients increases lipid risk factors for atherosclerosis

Abstract

Diabetic patients are at high risk of cardiovascular disease and the risk isamplified in the presence of nephropathy, which may be partially attributed tomodifications in lipoproteins. Moreover, lipoprotein profile may be affected byincipient nephropathy, glomerulopathy, and mild or severe renal failure. The aim of our study was to evaluate whether chronic renal failure (CRF) changeslipoprotein profile and apo A-I urinary excretion in diabetic subjects withglomerulopathy in comparison with non-diabetic subjects with glomerulopathy andCRF. Diabetic (n=25) and non-diabetic (n=10) patients with glomerulopathy and CRFshowed significantly higher LDL-cholesterol, non-HDL-cholesterol andHDL-triglyceride levels than diabetic individuals without CRF (n=10).Arylesterase and paraoxonase activities did not show any difference betweengroups. Apo A-I could not be detected in urine samples from diabetic patientswithout CRF. All diabetic subjects with glomerulopathy and CRF who presentedproteinuria above 6.5 g/24 h showed detectable urinary apo A-I (range=13.1-61.0mg/24 h). Similarly, all non-diabetic patients with glomerulopathy and CRF whohad proteinuria above 8.0 g/24 h also evidenced detectable apo A-I in urine(range=25.6-557.3 mg/24 h). Urinary apo A-I showed positive and significantcorrelations with urea (r=0.73, p<0.05) and proteinuria (r=0.97, p<0.0001), and anegative correlation with albumin plasma levels (r=-0.68, p<0.05). In conclusion,the presence of CRF in diabetic patients was associated with a more atherogeniclipoprotein profile.