Malondialdehyde-modified LDL-related variables are associated with diabetic kidney disease in type 2 diabetes
Malondialdehyde-modified LDL-related variables are associated with diabetic kidney disease in type 2 diabetes
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DOI：
10.1016/j.diabres.2018.05.019
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发表时间：
2018-07-01
影响因子：
5.1
通讯作者：
Shimano，Hitoshi
中科院分区：
文献类型：
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作者：
Furukawa，Shoko;Suzuki，Hiroaki;Shimano，Hitoshi
背景与目的氧化低密度脂蛋白（oxLDL）可引起动脉粥样硬化和肾损伤。尽管有报道称2型糖尿病伴大量白蛋白尿患者的循环oxLDL水平升高，但尚不清楚白蛋白尿或肾小球滤过率（GFR）降低是否与循环oxLDL水平独立相关。本研究旨在阐明糖尿病肾病分期与血清丙二醛修饰低密度脂蛋白（MDA-LDL）及MDA-LDL/LDL -胆固醇比值（MDA-LDL/LDL）的关系。方法和结果这项回顾性横断面研究使用了402例2型糖尿病患者的数据。排除进行血液透析的患者。血清MDA-LDL水平显著增加,增加蛋白尿的严重性(103 ± 44 U / L, 109 ± 54 U / L和135年 ± 72 U / L所料的正常蛋白尿,微蛋白尿和macroalbuminuria分别;P趋势 = 0.020)但不是根据估计的肾小球滤过率(GFR) (eGFR)。MDA-LDL /低密度脂蛋白增加率与增加蛋白尿显著相关(35 ± 13日37 ± 14岁和40 ± 15所料的正常蛋白尿,微蛋白尿和macroalbuminuria分别;P趋势 = 0.003)和减少表皮生长因子受体(34 ± 13日36 ± 13日38 ± 12,和51 ± 28为1级,2、3和4分别;P趋势 = 0.002)。多元线性回归分析显示，白蛋白排泄率和eGFR都不是血清MDA-LDL水平和MDA-LDL/LDL比值的独立决定因素，而ln-转化甘油三酯和LDL- c水平则不是。结论糖尿病肾病合并血脂异常患者血清MDA-LDL水平及MDA-LDL/LDL比值升高。
Background and aimsOxidized low-density lipoprotein (oxLDL) causes the development of atherosclerosis and kidney injury. Although circulating oxLDL levels were reportedly increased in type 2 diabetic patients with macroalbuminuria, it remains unclear whether albuminuria or the reduced glomerular filtration rate (GFR) is independently associated with the circulating oxLDL level. This study aimed to elucidate the association between the stage of diabetic nephropathy and serum malondialdehyde-modified LDL (MDA-LDL) and the ratio of MDA-LDL to LDL-cholesterol (MDA-LDL/LDL).Methods and resultsThis retroactive cross-sectional study used data from 402 patients with type 2 diabetes. Patients undergoing hemodialysis were excluded. Serum MDA-LDL levels were significantly increased with increases in severity of albuminuria (103 ± 44 U/L, 109 ± 54 U/L, and 135 ± 72 U/L for normoalbuminuria, microalbuminuria, and macroalbuminuria, respectively; P for trend = 0.020) but not according to the estimated GFR (eGFR). An increased MDA-LDL/LDL ratio was significantly associated with both increased albuminuria (35 ± 13, 37 ± 14, and 40 ± 15 for normoalbuminuria, microalbuminuria, and macroalbuminuria, respectively; P for trend = 0.003) and reduced eGFR (34 ± 13, 36 ± 13, 38 ± 12, and 51 ± 28 for grade 1, 2, 3 and 4, respectively; P for trend = 0.002). Multiple linear regression analysis showed that neither the albumin excretion rate nor eGFR but ln-transformed triglycerides and LDL-C levels were independent determinants of both serum MDA-LDL levels and MDA-LDL/LDL ratios.ConclusionSerum MDA-LDL levels and MDA-LDL/LDL ratios were increased in those with dyslipidemia associated with diabetic kidney disease.