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High HDL May Protect Against Albuminuria in Type 1 Diabetics

Higher levels of HDL cholesterol are associated with a decreased likelihood of albuminuria in patients with long-standing type 1 diabetes, three researchers from Chicago report.

Dr. Mark E. Molitch from Northwestern University and colleagues analyzed the lipid profiles of 107 patients who had type 1 diabetes for at least 20 years. Forty-two of them had albuminuria and 65 did not.

Total cholesterol, LDL cholesterol and triglyceride levels were similar in those with and without albuminuria. In contrast, HDL cholesterol levels were significantly lower in patients with albuminuria relative to those without albuminuria (1.42 vs 1.71 mg/dL; p < 0.01).

In age- and sex-adjusted analyses, a 10-mg/dL increase in HDL cholesterol was associated with an odds ratio of 0.70 for having albuminuria.

In a multivariate model that adjusted for age, sex, diabetes duration, and HbA1C, the odds of having albuminuria was halved (odds ratio 0.51) for every 21-mg/dL increase in HDL.

"I have long been looking for the reason why a number of patients with type 1 diabetes seem to have few complications despite suboptimal control. This may be one reason," Dr. Molitch told Reuters Health. "This is a very preliminary report that needs confirmation in larger numbers of patients," he emphasized.

"Whether the elevated HDL is in some way protective or whether it is somehow reflecting some other mechanism is unknown," Dr. Molitch added. "The data reported show only an association and not cause-and-effect and would not support the concept that patients should try to raise their HDL levels to prevent diabetic kidney disease."

Diabetes Care 2006;29:78-82.

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