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Lower levels of total HDL and HDL3 cholesterol are associated with albuminuria in normoalbuminuric type 1 diabetic patients

Previous studies have suggested a positive association between dyslipidemia and chronic kidney disease, but sparse data are available on the relation of lipids and urinary albumin excretion rate (UAE) in normoalbuminuric patients with normal renal function. The aim of this study was to evaluate the associations of serum lipids, including total, LDL, HDL, HDL2, HDL3 cholesterol, and triglyceride levels with UAE in normoalbuminuric type 1 diabetic patients. Study included 313 normoalbuminuric type 1 diabetic patients with normal or mild decrease renal function (estimated glomerular filtration rate (eGFR) > 60 ml min-1 1.73m-2) and before any interventions with statins, ACE inhibitors or angiotensin II receptor blockers. eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Subjects were classified as low-normoalbuminuric (UAE<11.0 mg/24h) or high-normoalbuminuric (UAE≥11.0 mg/24h) based on median UAE of at least two 24-h urine collections. Total HDL (1.74±0.4 vs 1.65±0.3 mmol/L, p=0.02) and HDL3 cholesterol (1.21±0.3 vs 1.13±0.3 mmol/L, p=0.01) levels were higher in low-normoalbuminuric subjects compared to high-normoalbuminuric subjects. In logistic regression analysis, after adjustment for age, sex, BMI, duration of diabetes and HbA1c, lower total HDL (odds ratio=0.43, 95% CI=0.22-0.82, p=0.01) and HDL3 cholesterol (odds ratio=0.34, 95% CI=0.15-0.76, p=0.009) were significantly associated with risk of higher UAE in our normoalbuminuric subjects. In this study of normoalbuminuric type 1 diabetic patients we have shown that elevated total HDL and HDL3 cholesterol may indicate a protection from the development of microalbuminuria.

type 1 diabetes; serum lipids; HDL cholesterol; albuminuria

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