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Russo GT, Manicardi V, Rocca A, Nicolucci A, Giandalia A, Lucisano G, Rossi MC, Graziano G, Di Bartolo P, De Cosmo S, Candido R, Di Cianni G. Severe Hypertriglyceridemia in Patients with Type 2 Diabetes Mellitus Participating in the AMD Annals Initiative. Metab Syndr Relat Disord 2024. [PMID: 39088376 DOI: 10.1089/met.2024.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024] Open
Abstract
Background: Familial chylomicronemia syndrome (FCS) is a rare inherited condition due to lipoprotein lipase deficiency, characterized by hyperchylomicronemia and severe hypertriglyceridemia. Diagnosis is often delayed, thus increasing the risk of acute pancreatitis and hospitalization. Hypertriglyceridemia is a common finding in patients with type 2 diabetes (T2D), who may harbor FCS among the most severe forms. Aim of the Study: We investigated the prevalence and clinical characteristics associated with severe hypertriglyceridemia in a range indicative of FCS, in a large population of subjects with T2D. Methods: Within the large population of the AMD Annals Initiative, patients with T2D with a lipid profile suggestive of FCS [triglycerides >880 mg/dL and/or high-density lipoprotein (HDL)-cholesterol <22 mg/dL or non-HDL-cholesterol ≤70 mg/dL] and their clinical features have been identified. Results: Overall, 8592 patients had triglyceride values >880 mg/dL in a single examination, 613 in two examinations, and 34 in three or more measurements. Patients with high triglyceride levels were mostly male (80%), with a relatively young age (54 years), short duration of diabetes (6.3 years), and elevated hemoglobin A1c (HbA1c) levels (9.4%). By stratifying this group of patients according to the severity of hypertriglyceridemia, more severe hypertriglyceridemia (triglyceride levels ≥2000 mg/dL) was associated with an even younger age (52 vs. 54 years), even higher mean HbA1c values (10.0% vs. 9.4%), and significantly higher HDL-cholesterol levels (37.9 vs. 32.4 mg/dL; P < 0.0001). Patients with persistently elevated triglyceride levels (n = 34), on three measurements, had a younger age; lower body mass index, HbA1c, and HDL-cholesterol levels; more frequent use of fibrates and insulin; and a higher prevalence of major cardiovascular events. Conclusions: Severe hypertriglyceridemia is a frequent condition in outpatients with T2D participating in the AMD Annals Initiative, and it is associated with male sex, young age, short disease duration, and a worse glycemic profile. Among patients with persistent severe hypertriglyceridemia, hidden FCS may be present.
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Affiliation(s)
- Giuseppina T Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Alberto Rocca
- G. Segalini H. Bassini Cinisello Balsamo ASST Nord, Milan, Italy
| | - Antonio Nicolucci
- CORESEARCH, Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Annalisa Giandalia
- Department of Human Pathology of Adulthood and Childhood "G. Barresi," University of Messina, Messina, Italy
| | - Giuseppe Lucisano
- CORESEARCH, Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Maria Chiara Rossi
- CORESEARCH, Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Giusi Graziano
- CORESEARCH, Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Paolo Di Bartolo
- Diabetes Unit, Local Healthcare Authority of Romagna, Ravenna, Italy
| | - Salvatore De Cosmo
- Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza," San Giovanni Rotondo, Italy
| | - Riccardo Candido
- Department of Medical Surgical and Health Sciences, University of Trieste, Diabetes Center, ASUGI, Trieste, Italy
| | - Graziano Di Cianni
- ASL North-West Tuscany, Diabetes and Metabolic Diseases, Livorno Hospital, Livorno, Italy
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Beniwal A, Jain JC, Jain A. Lipids: A Major Culprit in Diabetic Nephropathy. Curr Diabetes Rev 2024; 20:60-69. [PMID: 38018185 DOI: 10.2174/0115733998259273231101052549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/13/2023] [Accepted: 09/28/2023] [Indexed: 11/30/2023]
Abstract
The pathophysiology of diabetic nephropathy (DN) is too complex and involves a variety of pathways and mediators. Hyperglycaemia and dyslipidemia are identified as major risk factors for diabetic nephropathy. Various studies revealed the fact that dyslipidemia is a major contributor to the process of diabetic nephropathy. Dyslipidemia refers to abnormal lipid levels. Lipids like LDL, free fatty acids, abnormal lipoproteins, ceramides, etc., are unsafe for kidneys. They target proximal tubular epithelial cells, podocytes, and tubulointerstitial tissues through biochemical changes, especially by enhancing the release of reactive oxygen species (ROS) and lipid peroxidation, endorsing tissue inflammation and mitochondrial damage, which give rise to nephropathy. Major lipid targets identified are SREBP1, LXR, FXR PPAR, CD-36, PKc, AGE/RAGE pathway, and ferroptosis. The drug acting on these targets has shown improvement in DN patients. Various preclinical and clinical studies support the fact that hyperlipidemic agents are promising targets for DN. Therefore, in conjunction with other standard therapies, drugs acting on dyslipidemia can be added as a part of the regimen in order to prevent the incidence of ESRD and CVD.
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Affiliation(s)
- Ankita Beniwal
- College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Jasmine Chaudhary Jain
- College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Akash Jain
- College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
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Barrera Echegoyen FX, Szeto A, Mendez AJ, Garg R, Goldberg RB. The nature and characteristics of hypertriglyceridemia in a large cohort with type 2 diabetes. J Diabetes Complications 2023; 37:108387. [PMID: 36669323 DOI: 10.1016/j.jdiacomp.2022.108387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/15/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
AIMS To determine the prevalence of mild, moderate and severe hypertriglyceridemia (HTG) in a large, diverse healthcare system cohort with type 2 diabetes (T2D) and to study associations between triglyceride levels and demographic factors, glycemic control, body weight and to investigate whether triglyceride levels associate with markers of fatty liver and renal disease. METHODS 19,086 individuals with T2D were studied between 2015 and 2020. We compared groups with normotriglyceridemia (<150 mg/dl [<1.7 mmol/l]), mild (150-199 mg/dl [1.7-2.25 mmol/l]), moderate (200-499 mg/dl [2.26-5.64 mmol/l]) or severe HTG (>499 mg/dl [>5.64 mmol/l]). We also performed univariate and multivariate correlational analyses with triglyceride level as a continuous variable. RESULTS 39 % had triglyceride levels ≥150 mg/dl (<1.7 mmol/l), 19 % had moderate and 2 % had severe HTG. There was a lower proportion of Blacks in all HTG categories compared to Whites. There was no overall gender difference in prevalence except that severe HTG was more common in men and as HTG severity worsened mean age fell. Triglycerides correlated with HbA1c and associated with BMI, LDL-C, diastolic BP, transaminases and urine albumin/creatinine ratio, independent of HbA1c. CONCLUSION This study fills gaps in our knowledge of the distribution and clinical associations of HTG in T2D and characterizes the features of the small but important group with severe HTG. We demonstrate the influence of age, sex and race, confirm the moderate effects of glycemic control and obesity on triglyceride level, and provide evidence that triglyceride levels may be a marker for fatty liver and nephropathy independent of glycemic control.
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Affiliation(s)
- Francisco X Barrera Echegoyen
- Division of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Angela Szeto
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | - Armando J Mendez
- Division of Endocrinology Diabetes and Metabolism, Department of Medicine, Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Rajesh Garg
- Division of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Ronald B Goldberg
- Division of Endocrinology Diabetes and Metabolism, Department of Medicine, Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
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Hukportie DN, Li F, Zhou R, Zheng J, Wu X, Zou M, Wu X. Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis. J Diabetes 2022; 14:365-376. [PMID: 35668633 PMCID: PMC9366577 DOI: 10.1111/1753-0407.13273] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/28/2022] [Accepted: 05/09/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Greater lipid variability may cause adverse health events among diabetic patients. We aimed to examine the effect of lipid variability on the risk of diabetic microvascular outcomes among type 2 diabetes mellitus patients. METHODS We assessed the association between visit-to-visit variability (measured by variability independent of mean) in high-density lipoprotein (HDL) cholesterol, low-density lipoprotein-cholesterol (LDL), triglyceride, and remnant cholesterol (RC) measurements among participants involved in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and the risk of incident microvascular outcomes, including nephropathy, neuropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. RESULTS There were 2400, 2470, and 2468 cases of nephropathy, neuropathy, and retinopathy during a follow-up period of 22 600, 21 542, and 26 701 person-years, respectively. Higher levels of HDL, triglyceride, and RC variability were associated with an increased risk of incident nephropathy and neuropathy. Compared with the lowest quartile, the fully adjusted HRs (95% CI) for the highest quartile of HDL, triglyceride, and RC variability for nephropathy risk were 1.57 (1.22, 2.01), 1.50 (1.18, 1.92), and 1.40 (1.09, 1.80), respectively; and for neuropathy, the corresponding risks were 1.36 (1.05, 1.75), 1.47 (1.14, 1.91), and 1.35 (1.04, 1.74), respectively. Null association was observed between LDL variability and all microvascular complications. Additionally, all associations of variability in the other lipids with retinopathy risk were null. CONCLUSION Among individuals with type 2 diabetes mellitus, HDL, triglyceride, and RC variability were associated with increased risks of nephropathy and neuropathy but not retinopathy. TRIAL REGISTRATION ClinicalTrials.gov., no. NCT00000620.
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Affiliation(s)
- Daniel Nyarko Hukportie
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Fu‐Rong Li
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
- School of Public Health and Emergency ManagementSouthern University of Science and TechnologyShenzhenChina
| | - Rui Zhou
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Jia‐Zhen Zheng
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
| | - Xiao‐Xiang Wu
- Department of General Surgery157 Hospital, General Hospital of Guangzhou Military CommandGuangzhouChina
| | - Meng‐Chen Zou
- Department of Endocrinology and Metabolism, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Xian‐Bo Wu
- Department of Epidemiology, School of Public HealthSouthern Medical UniversityGuangzhouChina
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Deng X, Zhao L, Guo C, Yang L, Wang D, Li Y, Xia H, Wang C, Cai Z, Li L, Zhao Z, Yuan G. Higher Serum Asprosin Level is Associated with Urinary Albumin Excretion and Renal Function in Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:4341-4351. [PMID: 33223841 PMCID: PMC7671462 DOI: 10.2147/dmso.s283413] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/21/2020] [Indexed: 01/22/2023] Open
Abstract
AIM We detected whether serum asprosin levels play a role in the occurrence and development of albuminuria in patients with type 2 diabetes mellitus (T2DM), which has not been previously discussed. METHODS Based on urinary albumin/creatinine ratio (UACR), 207 T2DM patients were divided into T2DM patients with normoalbuminuria (UACR<30 mg/g), microalbuminuria (30≤UACR<300 mg/g), and macroalbuminuria (UACR≥300 mg/g). Serum asprosin levels were determined by enzyme-linked immunosorbent assay. RESULTS Comparatively, the serum asprosin levels in T2DM patient groups with macroalbuminuria [2.37 (1.63-3.57)] and microalbuminuria [2.10 (1.60-2.90)] were significantly increased than the normoalbuminuria group [1.59 (1.18-2.09)] (P<0.001). Importantly, the serum level of asprosin was positively correlated with UACR (r=0.304, P<0.001), creatinine (r=0.157, P=0.024), blood urea nitrogen (BUN) (r=0.244, P<0.001), and negatively with glomerular filtration rate (eGFR) (r=-0.159, P=0.022). Furthermore, multiple stepwise regression analyses showed that asprosin was significantly and independently related to UACR, BUN, DBP, and LDL-C (P<0.05). Besides, after adjustment for the confounders, the serum asprosin level was constantly and independently associated with the development of albuminuria in T2DM patients [OR (95% CI): 2.003 (1.37~2.928), P <0.001]. CONCLUSION Obviously, the serum asprosin level was independently correlated with UACR in T2DM patients, which implies circulating asprosin may play an essential role in the pathogenesis of diabetic nephropathy.
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Affiliation(s)
- Xia Deng
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Li Zhao
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Chang Guo
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Ling Yang
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Dong Wang
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Yanyan Li
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Hong Xia
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Chenxi Wang
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Zhensheng Cai
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Lian Li
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Zhicong Zhao
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
| | - Guoyue Yuan
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu212001, People’s Republic of China
- Correspondence: Guoyue Yuan; Zhicong Zhao Department of Endocrinology, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu212001, People’s Republic of ChinaTel +86-13505289352; +86-18752965615 Email ;
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Saja MF, Cook HT, Ruseva MM, Szajna M, Pickering MC, Woollard KJ, Botto M. A triglyceride-rich lipoprotein environment exacerbates renal injury in the accelerated nephrotoxic nephritis model. Clin Exp Immunol 2018; 192:337-347. [PMID: 29405270 PMCID: PMC5980512 DOI: 10.1111/cei.13111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 12/11/2022] Open
Abstract
Hyperlipidaemia accompanies chronic renal disease either as a consequence of the renal dysfunction or as part of generalized metabolic derangements. Under both situations, the lipid profile is characterized by accumulation of triglyceride-rich lipoproteins (TGRLs). This lipid profile is recognized as a risk factor for cardiovascular complications. Whether it may pose a risk for renal injury as well remains unclear. A hyper-TGRL state was generated in C57BL/6 mice using poloxamer-407 (P-407) and immune complex-mediated renal injury was triggered using the accelerated nephrotoxic nephritis (ANTN) model. The hyper-TGRL animals were hypersensitive to ANTN demonstrated by greater haematuria and glomerular cellularity. These changes were accompanied by increased glomerular accumulation of CD68+ macrophages. The hypersensitive response to ANTN was not seen in low-density lipoprotein receptor knock-out mice fed with a high fat diet, where triglyceride levels were lower but cholesterol levels comparable to those obtained using P-407. These data indicate that a hyper-TGRL state might be more detrimental to the kidneys than low-density lipoprotein-driven hypercholesterolaemia during immune complex-mediated nephritis. We speculate that the hyper-TGRL environment primes the kidney to exacerbated renal damage following an inflammatory insult with increased accumulation of macrophages that may play a key role in mediating the injurious effects.
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Affiliation(s)
- M F Saja
- Department of Medicine, Imperial College London, London, UK
| | - H T Cook
- Department of Medicine, Imperial College London, London, UK
| | - M M Ruseva
- Department of Medicine, Imperial College London, London, UK
| | - M Szajna
- Department of Medicine, Imperial College London, London, UK
| | - M C Pickering
- Department of Medicine, Imperial College London, London, UK
| | - K J Woollard
- Department of Medicine, Imperial College London, London, UK
| | - M Botto
- Department of Medicine, Imperial College London, London, UK
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Bardini G, Innocenti M, Rotella CM, Giannini S, Mannucci E. Variability of triglyceride levels and incidence of microalbuminuria in type 2 diabetes. J Clin Lipidol 2015; 10:109-15. [PMID: 26892127 DOI: 10.1016/j.jacl.2015.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 07/06/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Experimental and clinical studies have shown a strong association between hypertriglyceridemia and diabetic nephropathy. A variability of triglyceride (TG) levels has been reported in diabetes. OBJECTIVES To investigate the relationship of TG variability with the incidence of microalbuminuria (albumin excretion rate > 20 μg/min), in patients with type 2 diabetes. METHODS A longitudinal, retrospective, observational study was performed on a consecutive series of 457 normoalbuminuric outpatients, with measurements of HbA1c, lipids and microalbuminuria thrice per year with 6.8-year follow-up. TG variability, defined as standard deviation of TG (TG-SD) and TG-SD adjusted for the number of visits was calculated. A nested case-control sensitivity analysis was performed to validate the results of the primary cohort study. RESULTS Incident microalbuminuria (N = 124, 27.1%) was associated with higher median TG-SD (33.6 mg/dL vs 29.0 mg/dL, P < .05) and TG-SD adjusted for the number of visits (31.4 mg/dL vs 26.7 mg/dL, P < .05). At multivariate (Cox) analysis, logTG-SD and adj-logTG-SD were significant predictors of incident microalbuminuria (hazard ratio 2.1 [1.1-4.2], P = .028 and 1.5 [1.1-3.3], P = .042, respectively). In the case-control analysis, time spent with TG > 150 mg/dL during the follow-up was significantly higher in cases vs controls (27.2 ± 19 vs 16.7 ± 12.5 months, P < .05) with hazard ratio 2.0 (1.1-5.1), P < .05, for adj-logTG-SD. CONCLUSIONS A higher intraindividual TG variability is a predictor of incident microalbuminuria in type 2 diabetes. In addition, time of exposure to elevated TG levels (>150 mg/dL) predicts incident microalbuminuria.
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Affiliation(s)
- Gianluca Bardini
- Department of Biomedical Clinical and Experimental Sciences, Obesity Agency, University of Florence and Careggi University Hospital, Florence, Italy
| | - Maddalena Innocenti
- Department of Biomedical Clinical and Experimental Sciences, Obesity Agency, University of Florence and Careggi University Hospital, Florence, Italy
| | - Carlo Maria Rotella
- Department of Biomedical Clinical and Experimental Sciences, Obesity Agency, University of Florence and Careggi University Hospital, Florence, Italy
| | - Stefano Giannini
- Section of Endocrinology, Department of Biomedical, Clinical and Experimental Sciences, University of Florence, Florence, Italy.
| | - Edoardo Mannucci
- Department of Geriatric Medicine, Diabetes Agency, Careggi University Hospital, Florence, Italy
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Behling-Kelly E. Serum lipoprotein changes in dogs with renal disease. J Vet Intern Med 2014; 28:1692-8. [PMID: 25273603 PMCID: PMC4895635 DOI: 10.1111/jvim.12450] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 07/09/2014] [Accepted: 08/05/2014] [Indexed: 11/27/2022] Open
Abstract
Background People with renal disease develop a dyslipidemia that contributes to progression of renal injury and development of cardiovascular disease. Lipoproteins in dogs with renal disease have not been investigated. Hypothesis Dogs with chronic kidney disease (CKD) have dyslipidemia characterized by increased lower density lipoproteins and decreased high‐density lipoproteins (HDLs). The degree of dyslipidemia is positively correlated with severity of disease, as reflected by serum creatinine concentration. Animals Prospective study of client‐owned dogs presented to the Cornell University Hospital for Animals: 29 dogs with confirmed CKD, 5 dogs with nephrotic syndrome (NS), and 12 healthy control dogs presented for routine vaccinations, dental cleaning, or owned by students. Methods Lipoprotein electrophoresis was used to quantify relative proportions of the 3 main classes of lipoproteins in canine serum: low‐density lipoproteins (LDL), very low‐density lipoproteins (VLDL), and HDL. Serum cholesterol and creatinine concentrations; urinalysis and urine protein‐to‐creatinine ratio were measured by standard methods. Results Dyslipidemia was consistently found in dogs with CKD and NS and was characterized by a decrease in HDL and variable increases in LDL and VLDL. Dogs with NS had a proportionately greater increase in the VLDL fraction, as compared with dogs with CKD. Conclusion and Clinical Importance Dyslipidemia similar to that documented in people with renal disease occurs in dogs with CKD, despite serum cholesterol concentrations often being within the reference interval. The contribution of altered lipoproteins to the pathogenesis of renal disease in dogs warrants additional study.
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Affiliation(s)
- E Behling-Kelly
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
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