Non–high-density lipoprotein cholesterol is associated more closely with albuminuria in Chinese type 2 diabetic patients with normal renal function, compared with traditional lipid parameters

Abstract

Urinary albumin excretion rate (UAER) is a remarkable index reflecting the progression of kidney disease in diabetic subjects. The link between UAER and lipid metabolism is still unclear. The correlation of Apolipoprotein B (ApoB) to albuminuria has been investigated. The National Cholesterol Education Program-Adult Treatment Panel III recommends that clinicians consider non-high-density lipoprotein cholesterol (non-HDL-c) as a surrogate marker for ApoB. We sought to evaluate the relationship of UAER with lipid profile, especially with non-HDL-c in type 2 diabetic patients without renal dysfunction. A total of 507 type 2 diabetic patients with normal renal function participated in this study. Demographic and anthropometric data were collected; 24-hour urine samples were collected for UAER measurement. Blood samples were collected for lipid parameters and HbA1c measurement. The patients with albuminuria had greater levels of non-HDL-c and ApoB. The frequencies of albuminuria among the four quartiles of lipid parameters, ie, triglycerides, total cholesterol, non-HDL-c, and ApoB, demonstrated significantly linearly increasing (P for trend <.01). After adjustment, UAER was significantly correlated with total cholesterol, triglycerides, ApoB, and non-HDL-c but not with low-density lipoprotein cholesterol (LDL-c) or lipoprotein(a) [Lp(a)]. Stepwise regression analysis showed that age (β= .255, P= .000), systolic blood pressure (β= .261, P= .000), non-HDL-c (β= .164, P= .000), and duration of diabetes (β= .105, P= .024) were independently correlated with UAER in diabetic patients without renal dysfunction. Compared with the lipid parameters of total cholesterol, triglycerides, HDL-c, LDL-c, ApoB, Apolipoprotein A-I (ApoA-I), and Lp(a), non-HDL-c was more closely associated with albuminuria in Chinese type 2 diabetic patients without impaired renal function.