An implication of hypertriglyceridemia in the progression of diabetic nephropathy in metabolically obese, normal weight patients with type 2 diabetes mellitus in Korea

Abstract

This study was undertaken to investigate diverse risk factors affecting the progression of diabetic nephropathy (DN) by observing the changes of 24h urinary albumin excretion (24h UAE) in 90 abdominally obese, normal weight, type 2 diabetic patients with normo- or micro-albuminuria.Patients were divided into three groups according to the 24h UAE; normo-, micro-, and macro-albuminuria group. After 4 years of follow-up, patients were divided into either progression or non-progression group according to the changes of 24h UAE.About 37% of the normo-albuminuria group and 18% of the micro-albumiuria group were classified into the progression group. The initial serum creatinine levels and the initial and follow-up post-prandial plasma glucose levels were significantly higher in the progression group than in the non-progression group. Most remarkably, the initial and follow-up serum triglyceride (TG) levels (190 ± 132 versus 132 ± 49mg/dl and 191 ± 124 versus 133 ± 41mg/dl, P < 0.01 in both) were significantly higher in the progression group than in the non-progression group, suggesting hypertriglyceridemia might be included in the progression factors of DN. The increases in 24-hour UAE were positively associated with the initial and follow-up post-prandial plasma glucose levels (P < 0.05 in both), the initial and follow-up serum creatinine levels (P < 0.05 in both), and the initial serum TG levels (P < 0.05). Whereas, insulin users or patients with retinopathy at follow-up (P < 0.05 in both) showed more rapid progression of albuminuria, ACE inhibitors or acarbose (P < 0.05 in both) use turned out to protect against it.