MULTIPLE LIPOPROTEIN ABNORMALITIES IN TYPE-I DIABETIC-PATIENTS WITH RENAL-DISEASE

The aim of this study was to characterize abnormalities of triglycerid e-rich apolipoprotein (ape) B-containing lipoproteins in type I diabet ic patients with elevated albumin excretion rates (AERs), Sixty-four p atients (31 men, 33 women) with normoalbuminuria (AER <20 mu g/min), 5 2 (35 men, 17 women) with microalbuminuria (AER 20-200 mu g/min), and 37 (17 men, 20 women) with albuminuria (AER >200 mu g/min) and 56 heal thy control subjects matched for age and body weight were studied. The major finding was increased mass concentrations of the highly atherog enic intermediate-density lipoprotein fraction in patients with microa lbuminuria (P < 0.05) and albuminuria (P < 0.05), compared with those with normoalbuminuria, Triglyceride, free cholesterol, cholesterol est er, and phospholipid concentrations in the VLDL, intermediate-density lipoprotein, and LDL (P < 0.05-0.01), as well as total cholesterol, to tal triglyceride, and apoB concentrations were higher in patients with renal disease than in those without. Notably, there were no differenc es between patients with microalbuminuria and albuminuria. Only minor compositional changes could be detected, Postheparin plasma lipoprotei n lipase (LPL) activities were identical, but hepatic lipase activitie s were higher in microalbuminuric and albuminuric patients than in nor moalbuminuric patients (P < 0.01), LPL activity and VLDL(1) (S-f 60-40 0) (r = -0.528; P < 0.001) and VLDL(2) (S-f 20-60) mass concentrations (r = -0.471; P < 0.001) were negatively related, In conclusion, in ty pe I diabetic patients with early renal disease, there are multiple li poprotein changes, which are potentially atherogenic and may contribut e to the excess of macrovascular complications seen in such patients.