Dataset Information

Association of serum high-density lipoprotein cholesterol with microalbuminuria in type 2 diabetes patients.

ABSTRACT:

Background

The association of serum high-density lipoprotein cholesterol (HDL-C) with microalbuminuria in type 2 diabetes mellitus (T2DM) remains controversial. Therefore, a cross-sectional study was conducted on patients with T2DM to investigate the relationship of HDL-C with microalbuminuria.

Methods

A total of 524 participants with T2DM were recruited in this cross-sectional study. The patients were divided into four groups according to serum HDL-C quartile. A nonparametric test was employed to assess the relationships across quartiles with clinical parameters and demographics. Multivariate logistic regression analysis was further performed.

Results

Of the 524 patients, 138 (26.3%) were found to have microalbuminuria by urinary albumin excretion rate determination. Serum HDL-C levels in microalbuminuria group were significantly lower than those in non-microalbuminuria group (1.04 (0.90-1.21) vs. 1.10 (0.94-1.31) mmol/L, P = 0.002). The nonparametric test for trend showed that the prevalence of microalbuminuria was significantly reduced for subjects of the fourth quartile of HDL-C compared to the first to third quartile (13.5% vs. 33.1%, 28.6%, 29.4%, P = 0.001). Multivariate logistic regression showed that subjects within the highest quartile of HDL-C had lower odds of microalbuminuria than those within the lowest quartile of HDL-C (OR = 0.17, 95% CI 0.15-0.52, P = 0.004).

Conclusions

Higher levels of serum HDL-C were associated with decreased rates of microalbuminuria in T2DM patients.

SUBMITTER: Sun X

PROVIDER: S-EPMC6173850 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Association of serum high-density lipoprotein cholesterol with microalbuminuria in type 2 diabetes patients.

Sun Xun X Xiao Ye Y Li Pei-Mei PM Ma Xiu-Yun XY Sun Xiao-Jie XJ Lv Wen-Shan WS Wu Yi-Li YL Liu Peng P Wang Yan-Gang YG

Lipids in health and disease 20181005 1

<h4>Background</h4>The association of serum high-density lipoprotein cholesterol (HDL-C) with microalbuminuria in type 2 diabetes mellitus (T2DM) remains controversial. Therefore, a cross-sectional study was conducted on patients with T2DM to investigate the relationship of HDL-C with microalbuminuria.<h4>Methods</h4>A total of 524 participants with T2DM were recruited in this cross-sectional study. The patients were divided into four groups according to serum HDL-C quartile. A nonparametric tes ...[more]

PMID: 30290810

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Project description:The evidence for the association between the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-c) ratio and the risk of developing microalbuminuria is still limited in the Chinese population. Therefore, our research will endeavor to explore the relationship between the two. The cross-sectional survey enrolled 32,877 general population from eight regional centers in China. If the urinary albumin-creatinine ratio (UACR) ≥ 30 mg/g, it was considered microalbuminuria. The dependent variable in the study was microalbuminuria, while the independent variable was the TG/HDL-c ratio. A binary logistic regression model was utilized to examine the independent association between the likelihood of microalbuminuria and the TG/HDL-c ratio. A generalized additive model (GAM) and spline smoothing were employed to investigate non-linear relationships between these two variables. To confirm the findings and pinpoint important turning points, subgroup and threshold effect tests were performed. The average age of the study participants was 57.67 ± 9.29 years, with 22,052 (67%) females and 10,825 (33%) males. The ratio of TG/HDL-c had a median value of 1.06, while the UACR had a median value of 9.92 mg/g. The prevalence of microalbuminuria was 14.4%. Following covariate adjustment, the prevalence of microalbuminuria and the TG/HDL-c ratio showed a significant positive connection (OR = 1.17,95% CI 1.13-1.21). Interestingly, we discovered a non-linear relationship between the occurrence of microalbuminuria and the TG/HDL-c ratio. At a TG/HDL-c ratio of 0.911, we detected an inflection point, with ORs of 1.12 (95% CI: 1.08, 1.17) on the right side of the point and 1.89 (95% CI: 1.51, 2.36) on the left. Subgroup analyses further validated the results. Our research revealed a positive and non-linear connection between the TG/HDL-c ratio and the prevalence of microalbumin in Chinese individuals. The connection was especially robust when the TG/HDL-c ratio was below 0.911. Reducing TG or raising HDL-c levels in order to lower the TG/HDL-c ratio may significantly mitigate the risk of microalbuminuria.

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Project description:There is accumulating evidence that serum levels of non-high-density lipoprotein cholesterol (non-HDL-C) are a more accurate predictor of cardiovascular outcomes when compared with low-density lipoprotein cholesterol. However, we recently found that higher serum concentrations of triglycerides are associated with better outcomes in patients undergoing hemodialysis. Therefore, we hypothesized that the association of serum levels of non-HDL-C (which includes triglyceride-rich lipoproteins) with outcomes may also be different in patients undergoing hemodialysis when compared with other patient populations. We studied the association of baseline and time-dependent serum levels of non-HDL-C with all-cause and cardiovascular mortality using Cox proportional hazard regression models in a nationally representative cohort of 50 118 patients undergoing incident hemodialysis from January 1, 2007, to December 31, 2011. In time-dependent models adjusted for case mix and surrogates of malnutrition and inflammation, a graded inverse association between non-HDL-C level and mortality was demonstrated with hazard ratios (95% confidence intervals) of the lowest (<60 mg/dL) and highest (≥160 mg/dL) categories: 1.88 (1.72-2.06) and 0.73 (0.64-0.83) for all-cause mortality and 2.07 (1.78-2.41) and 0.75 (0.60-0.93) for cardiovascular mortality, respectively (reference, 100-115 mg/dL). In analyses using baseline values, non-HDL-C levels <100 mg/dL were also associated with significantly higher mortality risk across all levels of adjustment. Similar associations were found when evaluating non-HDL/HDL cholesterol ratio and mortality, with the highest all-cause and cardiovascular mortality being observed in patients with decreased non-HDL/HDL-C ratio (<2.5). Contrary to the general population, decrements in non-HDL-C and non-HDL/HDL cholesterol ratio were paradoxically associated with increased all-cause and cardiovascular mortality in patients undergoing incident hemodialysis. The underlying mechanisms responsible for these associations await further investigation.

Dataset Information

Association of serum high-density lipoprotein cholesterol with microalbuminuria in type 2 diabetes patients.

Background

Methods

Results

Conclusions

Publications

Association of serum high-density lipoprotein cholesterol with microalbuminuria in type 2 diabetes patients.

Similar Datasets

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