Correlation of ApoB/ApoA1 with diabetic nephropathy

ABSTRACT

Introduction: Diabetic nephropathy is a microvascular complication and is the leading cause of diabetes related morbidity, mortality and important cause of end-stage kidney disease. Both microalbuminuria and macroalbuminuria are associated with increased risk of cardiovascular disease. Evidence has been accumulating from clinical trials that assessing the levels of apolipoprotein B (ApoB), a constituent of atherogenic lipoproteins ApoA1, a component of anti-atherogenic high density lipoprotein (HDL) cholesterol; and the ApoB/ApoA1 ratio will provide better prediction of future cardiovascular events than measuring serum low-density lipoprotein (LDL)-cholesterol levels. There is paucity of published data linking ApoB/ApoA1 ratio to diabetic nephropathy especially from developing countries, hence this study was carried out. Materials and Methods: The present study was conducted in the Department of Medicine, CSM Medical University, Lucknow between August 2009 and July 2010. Patients with type 2 Diabetes Mellitus (DM) attending the Diabetic and Medical Out-Patient clinics or who were admitted to the medical wards of Gandhi Memorial and Association Hospital CSM University, Lucknow were included. One hundred patients were enrolled; 64 of those were cases (Micro- and Macroalbuminuria groups) and 36 without nephropathy (Normoalbuminuria) were controls. The cut-off value for higher ApoB/ApoA1 ratio for male was 0.97 and for female was 0.86. Results: Older age, durations and control of DM were significantly correlated with degree of albuminuria. Fifty-six patients (56%) had raised ApoB/ApoA1 ratio, 19.4% in the Normoalbuminuria group (n=7/36), 71.4% in the Microalbuminuria group (n=30/42), and 86.4% in the Macroalbuminuria group (n=19/22). There were no statistical differences in the mean total cholesterol, HDL, LDL, triglycerides among the groups. Conclusion: In our study higher ApoB/ApoA1 ratio was significantly correlated with diabetic nephropathy.