Serum lipids status in patients with diabetic uremia on 10 years of maintenance hemodialysis

Background. Dyslipidemia in patients with diabetic uremic patients remains unclear. We previously reported that lipid abnormalities in diabetic uremia on short-term (3 to 28 months) hemodialysis therapy were more severe than those in nondiabetic uremic patients. The object of this study is to invest igate the serum lipid profiles in diabetic uremic patients on 10 years of m aintenance hemodialysis treatment. Methods. Thirty diabetic uremic subjects and 40 age-matched nondiabetic sub jects on long-term hemodialysis therapy were selected, and their clinical c haracteristics and serum concentrations of lipids, apolipoproteins, lecithi n cholesterol acyltransferase (LCAT) activity, and apolipoprotein (apo) E p henotype were evaluated, Results. Patients with diabetic uremia had a higher prevalence of macrovasc ular complications, including ischemic heart diseases and cerebrovascular d iseases. The mean levels of serum total cholesterol, triglyceride, and high -density lipoprotein cholesterol remained normal. Nondiabetic uremic patien ts exhibited a reduction in serum apo A-1, serum apo A-2, serum apo C-2, an d LCAT activity and an increase in serum Apo C-3, Diabetic uremic patients showed a further reduction in serum apo A-1. serum apo A-2, serum apo E, an d LCAT activity. Frequencies of apo E isoforms were not significantly diffe rent between two groups of uremic patients. Conclusions. These results clearly indicate that lipid abnormalities in dia betic uremic patients on long-term hemodialysis therapy are more enhanced t han those in nondiabetic uremic patients. suggesting that diabetic hemodial yzed patients an more prone to increase the individual risk for accelerated atherosclerosis to cause a higher incidence of cardiovascular diseases.