Remnant-like particle-cholesterol concentrations in patients with type 2 diabetes mellitus and end-stage renal disease

Background: Lipid abnormalities contribute significantly to the increased r isk of cardiovascular disease in diabetic and end-stage renal disease (ESRD ) patients. Accumulating evidence supports a proatherogenic role for remnan t lipoproteins. Thus, the aim of the present study was to compare remnant-l ike particle-cholesterol (RLP-C) in type 2 diabetic and ESRD patients with age- and gender-matched controls. Methods: Using an immunoaffinity assay, we measured RLP-C concentrations in 48 type 2 diabetic patients with (n = 24) and without (n = 24) macrovascul ar complications, and 24 age- and gender-matched controls, as well as in 38 ESRD patients on hemodialysis (n = 19) and peritoneal dialysis (n = 19), a nd 19 age- and gender-matched controls. Results: RLP-C correlated significantly with plasma triglycerides (TGs; r = 0.8). When compared with controls, RLP-C concentrations were significantly higher in type 2 diabetic patients with and without macrovascular complica tions (median, 0.22 and 0.17 mmol/L vs 0.14 mmol/L; P <0.0002 and <0.01, re spectively); diabetic patients with macrovascular complications also had si gnificantly higher RLP-C than diabetic patients without macrovascular compl ications (P <0.05). However, when RLP-C/TG ratios were computed, only diabe tic patients with macrovascular complications showed significantly higher R LP-C/TG ratios compared with controls (P <0.05). Regarding ESRD, RLP-C conc entrations were significantly increased in patients on both hemodialysis an d peritoneal dialysis compared with controls (median, 0.23 and 0.21 mmol/L vs 0.13 mmol/L; P <0.0001). Whereas RLP-C was increased in ESRD patients on hemodialysis with TGs <2.26 mmol/L compared with controls, RLP-C/TG ratios were not significantly increased in these patients. Conclusions: Type 2 diabetic patients with macrovascular disease demonstrat ed increased RLP-C and RLP-C/TG ratios, whereas ESRD patients showed only i ncreased RLP-C concentrations. (C) 2000 American Association for Clinical C hemistry.