Correlation between high density lipoprotein cholesterol and kidney function in type 1 diabetes as a predictor of diabetic nephropathy in human subjects
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Date
2016-04
Authors
Mugeni, Wanyama Francis
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Diabetic nephropathy (DN) is a common microvascular complication occurring
five years from onset of type 1 diabetes mellitus, leading to renal failure and death.
It is characterized by albuminuria and a reduced glomerular filtration rate.
Although much emphasis has been placed on screening for albuminuria and
estimated glomerular filtration rate (eGFR) to predict or diagnose DN, less
attention has been focused on the role of high density lipoprotein cholesterol
(HDL-C) in risk assessment of DN onset. The aim of the present study was to
evaluate the association between HDL-C levels and the markers of kidney
functions, urinary albumin creatinine ratio (UACR) and eGFR, in patients with
type 1 diabetes mellitus. In total, 89 type 1 diabetic mellitus patients attending
Kenyatta National Hospital were recruited. A questionnaire was administered to
ascertain age, gender, marital status, education level, family history of kidney
disease and the diabetes duration. The following parameters were measured: blood
pressure, body mass index, UACR, eGFR, total and HDL cholesterol. Data
analysis was done using SPSS version 20.0. Chi squared test was used to analyse
categorical variables of states of UACR, HDL-C and eGFR against the
demographic and clinical risk factors. While for analysis of between group
continuous variables, t test, one way ANOVA and Pearson correlation statistics
were applied. The values of UACR, HDL-C and eGFR levels in the study
population ranged from 3–300 mg/g, 0.45–3.45 mmol/l and 29.1–240.5
ml/min/1.73m2, respectively. The number of participants with abnormal levels of
UACR, HDL-C and eGFR were 45%, 14%, and 22%, respectively. The UACR
and HDL-C values were significantly associated with the risk factors of: duration
of diabetes, systolic and diastolic blood pressure (p < 0.05). The confounding
factor of marital status was only significantly associated with UACR levels. On the
other hand eGFR was not associated with any of the patients tested characteristics
(p > 0.05). The HDL-C values were significantly lower in the subjects with
albuminuria compared to normoalbuminuric group (p = 0.001). There was no
significant association or correlation between HDL-C and eGFR values (r = 0.029;
p > 0.05). Therefore, eGFR does not add predictive value of diabetic nephropathy
among patients with type 1 diabetes mellitus. However, there was a significant
inverse correlation between HDL-C and UACR level (r = -0.394; p < 0.05).
Therefore, HDL-C has the potential to alternately predict the development of
nephropathy levels among patients with a long standing case of type 1 diabetes
mellitus.
Description
A thesis submitted in partial fulfillment of the requirements for the award of the
Degree of Master of Science (Medical Biochemistry) in the School of Pure and
Applied Sciences of Kenyatta University