Document Detail

Effects of albuminuria and renal dysfunction on development of dyslipidaemia in type 2 diabetes--the Hong Kong Diabetes Registry.
MedLine Citation:
PMID:  18372388     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is uncertain whether albuminuria precedes the future development of high total cholesterol (TC > 6.2 mmol/l) and high LDL-C (>4.1 mmol/l) while renal dysfunction precedes the future development of low HDL-C (<0.9 mmol/l) in type 2 diabetes. METHODS: A prospective cohort of 2761 type 2 diabetic patients without significant dyslipidaemia and having at least one measurement of TC, LDL-C and HDL-C during 2.8 years of follow-up was analysed. The spline Cox regression model was used to derive hazard ratio (HR) curves of the spot urinary albumin:creatinine ratio (ACR) and the estimated glomerular filtration rate (eGFR) for dyslipidaemia, followed by standard Cox models to confirm the findings from the HR curves. RESULTS: Seven percent of the cohort developed high TC, 4.6% developed high LDL-C and 5.7% developed low HDL-C during follow-up. In multivariate analysis, the HR of ACR for high TC and high LDL-C increased rapidly and linearly from zero with no apparent threshold. Patients with macroalbuminuria (ACR >/=25 mg/mmol) were, respectively, 1.6- and 2.4 folds more likely to develop high TC and high LDL-C than those with normoalbuminuria at baseline. The HR of eGFR for low HDL-C increased rapidly with declining eGFR at <110 ml/min/ 1.73 m(2). Subjects with eGFR <60 ml/min/1.73 m(2) and >/=60-<110 ml/min/1.73 m(2), respectively, had 3.0-fold and 1.8-fold risks of low HDL-C compared to those with eGFR >/=110-<140 ml/min/1.73 m(2). CONCLUSIONS: In type 2 diabetes, macroalbumninuria predicts high TC and high LDL-C, while reduced renal function, even within normal range, predicts low HDL-C.
Xilin Yang; Wing Yee So; Ronald Ma; Gary Ko; Alice Kong; Christopher Lam; Chung Shun Ho; Clive Cockram; Chun-Chung Chow; Peter Tong; Juliana Chan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-27
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  23     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-19     Completed Date:  2009-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2834-40     Citation Subset:  IM    
Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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MeSH Terms
Albuminuria / epidemiology*
Cholesterol / blood
Diabetes Mellitus, Type 2 / blood*,  epidemiology*
Dyslipidemias / epidemiology*
Hong Kong
Lipoproteins, HDL / blood
Lipoproteins, LDL / blood
Middle Aged
Prospective Studies
Renal Insufficiency / blood*,  epidemiology*
Risk Factors
Reg. No./Substance:
0/Lipoproteins, HDL; 0/Lipoproteins, LDL; 57-88-5/Cholesterol

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