Elevated HDL Levels Associated With Less Risk for Albuminuria in Long Standing T

Elevated HDL Levels Associated With Less Risk for Albuminuria in Long Standing Type 1 Diabetes

Higher HDL cholesterol levels may be protective against the development of albuminuria in patients with type 1 diabetes.

The objective of this study was to determine whether high levels of HDL cholesterol are associated with a lower prevalence of albuminuria

They analyzed the lipid profiles of patients with type 1 diabetes of 20 years duration in 42 patients with albuminuria (28 microalbuminuria and 14 macroalbuminuria) and 65 patients without increased albumin excretion before any interventions with either statins or ACE inhibitors.

The results showed that several characteristics were similar in the two groups: sex, age, duration of diabetes, total cholesterol, LDL cholesterol, and triglycerides. By univariate analysis, significant differences (P < 0.01) were found in HDL cholesterol (albuminuria 1.42 mg/dl, no albuminuria 1.71 mg/dl, P < 0.01), HbA1c (A1C) (albuminuria 8.5%, no albuminuria 7.5%), and proportions with no, background, and proliferative retinopathy (albuminuria 2.4, 16.7, and 81%; no albuminuria 24.6, 52.3, and 23.1%, respectively). When adjusted for age and sex, a 0.26-mmol/l (10-mg/dl) increase in HDL cholesterol is associated with an odds ratio (OR) of 0.70 (95% CI 0.54–0.90) for having albuminuria. In a multivariate model that adjusted for age, sex, diabetes duration, and A1C, for every 0.54-mmol/l (21-mg/dl) increase in HDL cholesterol, patients are approximately half (OR 0.51 [95% CI 0.30–0.86]) as likely to have albuminuria, even after controlling for A1C.

From the results it was concluded that higher HDL cholesterol levels may be protective against the development of albuminuria in patients with type 1 diabetes. Whether this is due to the HDL cholesterol levels or whether they serve as a marker for some other mechanism remains to be determined.

Diabetes Care 29:78-82, 2006

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FACT: Impaired fasting glucose, increase risk for cardiovascular disease (CVD): People with pre-diabetes, defined as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), are at high risk for diabetes and cardiovascular disease (CVD). The prevalence of IFG in US adolescents was recently estimated to be 7.0% overall and 17.8% in overweight subjects. Those with IFG were found to have other risk factors for diabetes and CVD, such as insulin resistance, an adverse lipid profile, and high systolic blood pressure. The authors state that their data provide a baseline for monitoring national trends, and they urge the need for diabetes prevention studies among adolescents. Pediatrics,116 (1122-1266): Williams D, Cadwell B, Cheng Y, Cowie C, Gregg E, Geiss L, Engelgau M, Narayan K, Imperatore G Prevalence of impaired fasting glucose and its relationship with cardiovascular disease risk factors in US adolescents, 1999-2000