Evaluation value of small dense low density lipoprotein cholesterol for early renal injury in patients with diabetes mellitus

Zhou Lizhong

doi:10.3760/j.issn.1673-4777.2019.07.013

Abstract：Objective To explore the evaluation value of small dense low density lipoprotein cholesterol (sdLDL-C) for early renal injury in patients with diabetes mellitus.Methods From January 2016 to January 2017,321 patients with type 2 diabetes mellitus were enrolled from departments of endocrinology and nephrology of Weifang People's Hospital,Shandong Province.They were detected urinary microalbumin excretion rate(UAER) and divided into normal albumin group(NA group,125 cases),microalbuminuria group (MA group,102 cases) and clinic nephropathy group (CN group,94 cases).One hundred and eight healthy people were enrolled as control group.Blood glucose,glycosylated hemoglobin(HbA1c),sdLDL-C,total cholesterol,triacylglycerol,high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholestero (LDL-C),apolipoprotein A,apolipoprotein B,homocysteine(Hcy) and cystatin C were detected.UAER and estimated glomerular filtration rate (eGFR) were measured.Correlations of eGFR with sdLDL-C and other indicators in CN group were analyzed by Pearson test.Risk factors of diabetic renal injury were analyzed by logistic regression.Results Levels of HDL-C and apolipoprotein A in NA,MA,CN groups were significantly lower,duration of diabetes,levels of blood glucose,HbA1c,sdLDL-C,triacylglycerol,LDL-C and Hcy were significantly longer/higher than those in control group(all P ＜ 0.05).Levels of sdLDL-C and UAER in MA group were significantly higher than those in NA group [(1.01 ± 0.42) mmol/L vs (0.88 ± 0.35) mmol/L,(169 ± 56) mg/24 h urine vs (18 ± 6) mg/24 h urine] (both P ＜ 0.05).Duration of diabetes,levels of sdLDL-C,total cholesterol,triacylglycerol,LDL-C,apolipoprotein B,Hcy,cystatin C and UAER in CN group were significantly higher and eGFR was significantly lower than those in NA group(all P ＜0.05).In CN group,eGFR was positively correlated with sdLDL-C,total cholesterol,triacylglycerol,LDL-C,apolipoprotein B and Hcy(r =0.556,0.301,0.221,0.385,0.495,0.519;all P ＜ 0.05);it was negatively correlated with HbA1c,HDL-C and apolipoprotein A(r =-0.245,-0.182,-0.168;all P ＜0.05).Logistic regression showed that duration of diabetes (odds ratio =1.233,P =0.018),sdLDL-C (odds ratio =3.452,P =0.012),total cholesterol (odds ratio =5.004,P =0.042) and apolipoprotein B (odds ratio =2.451,P =0.039) were independent risk factors of elevated UAER in diabetic patients.Conclusion There is significant correlation among sdLDL-C level,UAER and eGFR in patients with diabetes mellitus;sdLDL-C may be an early predictor of diabetic nephropathy.