Atherogenic Lipoproteins in Type 2 Diabetes with Nephropathy

Abstract

It is well known patients with diabetes have a high incidence of cardiovascular disease (CVD), and the incidence of CVD becomes substantially elevated when diabetic nephropathy is developed. The pathogenesis of CVD in diabetes is multifactorial, but dyslipidemia is thought to be a powerful risk factor for CVD. Although lipid metabolism has been extensively investigated in diabetes, little information is available concerning the influence of nephropathy on diabetic dyslipidemia. The mechanisms for dyslipidemia in diabetic nephropathy are multifactrial and complex. Plasma lipid profile are largely changed in the stage of nephropathy. Diabetes per.se. is a basic component causing plasma lipid abnormalities. Long-term hyperglycemia causes generalized vascular endothelial damage, which reduces functional lipoprotein lipase, leading to increase TG and decrease HDL-cholesterol. In overt-diabetic nephropathy, hypoproteinemia markedly increases LDL-C, and renal failure specifically increases remnant lipoproteins and decreases HDL-C and LDL-C. In this brief review, I will state how lipoprotein abnormalities worsen with increasing severity of diabetic nephropathy, and what lipoprotein changes are attributable to diabetes or kidney dysfunction based on our data.