High-density lipoprotein cholesterol (HDL-C) is an independent risk factor for the development of diabetic nephropathy, but not retinopathy, in patients with type 2 diabetes, according to new research.
Jamie Morton, M.B.B.S., of The Heart Research Institute in Sydney, and colleagues followed 11,140 patients in the Action in Diabetes and Vascular Disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) study, the participants of which had type 2 diabetes and at least one additional vascular risk factor. The ADVANCE study was designed to evaluate the association between HDL-C and microvascular disease (composite of renal and retinal events).
Over a median follow-up of five years, the researchers found that 28 percent of patients experienced a renal event and 6 percent experienced a retinal event. Compared with those in the highest third, patients in the lowest third of HDL-C levels had a 19 percent higher risk of renal events (17 percent higher risk of combined renal and retinal microvascular events). There was no association between HDL-C and retinal events (P = 0.9).
"In conclusion, in a large population of patients with type 2 diabetes and after adjustment for a wide variety of confounders, low HDL-C level was shown to be an independent risk factor for the development and progression of diabetic nephropathy," the authors write. "Measurement of this lipid fraction may be useful in tailoring screening and therapeutic strategies."
Published online before print August 13, 2012, doi: 10.2337/dc12-0306 Diabetes Care August 13, 2012 Abstract