Lipoprotein(a) predicts a new onset of chronic kidney disease in people with Type 2 diabetes mellitus
Aims We investigated the association between lipoprotein(a) [Lp(a)] level and new‐onset chronic kidney disease (CKD) in patients with Type 2 diabetes. Methods We conducted a prospective cohort study from March 2003 to December 2004 with a median follow‐up time of 10.1 years. Patients aged 25–75 year...
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Published in: | Diabetic medicine Vol. 33; no. 5; pp. 639 - 643 |
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Main Authors: | , , , , , , |
Format: | Journal Article |
Language: | English |
Published: |
England
Blackwell Publishing Ltd
01-05-2016
Wiley Subscription Services, Inc |
Subjects: | |
Online Access: | Get full text |
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Summary: | Aims
We investigated the association between lipoprotein(a) [Lp(a)] level and new‐onset chronic kidney disease (CKD) in patients with Type 2 diabetes.
Methods
We conducted a prospective cohort study from March 2003 to December 2004 with a median follow‐up time of 10.1 years. Patients aged 25–75 years with Type 2 diabetes and without CKD [estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m2) were consecutively enrolled. The eGFR was measured at least twice every year , and new‐onset CKD was defined as a decreased eGFR status of < 60 ml/min/1.73 m2 using a Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equation.
Results
Of the 862 patients who were enrolled, 560 (65.0%) completed the follow‐up and 125 (22.3%) progressed to CKD. The mean age and duration of diabetes were 53.3 ± 9.6 and 7.5 ± 6.0 years, respectively. The baseline eGFR was 101.8 ± 11.3 ml/min/1.73 m2. After adjusting for multiple confounding factors, a Cox hazard regression analysis revealed that the third tertile of Lp(a) was significantly associated with the development of CKD during the observation period when compared with the first tertile [hazard ratio 2.12 (95% confidence interval 1.33–3.36); P = 0.001).
Conclusions
In this prospective, longitudinal, observational cohort study, we demonstrated that the Lp(a) level was an independent prognostic factor for the future development of CKD in patients with Type 2 diabetes.
What's new?
Our study confirms that an elevated lipoprotein(a) level is an independent predictable risk factor for the future development of new‐onset chronic kidney disease in Type 2 diabetes.
The median calculated estimated glomerular filtration rate reduction showed an increasing trend as the lipoprotein(a) level increased.
We suggest that cardiovascular risk factors in patients with diabetes who have high lipoprotein(a) should be treated more aggressively to prevent the future development of chronic kidney disease. |
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Bibliography: | ark:/67375/WNG-XWM75BFN-P istex:0B50D2D1AEB352240B08C9F9682D049C7290E7F7 ArticleID:DME12862 Table S1. Comparison of baseline parameters between the patients who completed follow-up and patients with follow-up loss. Table S2. Multivariable Cox proportional hazards model for the predictable risk of chronic kidney disease according to tertile groups of lipoprotein(a). ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
ISSN: | 0742-3071 1464-5491 |
DOI: | 10.1111/dme.12862 |