Study on the relationship between lipoprotein (a) and diabetic kidney disease

• Published in: Journal of diabetes and its complications 2023-01, Vol.37 (1), p.108378-108378, Article 108378
• Main Authors: Wang, Anni, Zhang, Shaojie, Li, Yayu, Zhu, Fenggui, Xie, Bo
• Format: Article
• Language: English
• Subjects: Atherosclerosis; Cholesterol; Clinical medicine; Creatinine; Diabetes; Diabetes Mellitus, Type 2; Diabetic kidney disease; Diabetic Nephropathies; Diabetic nephropathy; Fatty acids; GFR; Glomerular Filtration Rate; Glomerular grade; High density lipoprotein; Humans; Hypertension; Kidney diseases; Kinases; Laboratories; Lipids; Lipoprotein(a); Lipoproteins; Lp (a); Metabolic disorders; Oxidative stress; Pathogenesis; Patients; Proteins; Proteinuria; Renal Insufficiency, Chronic - complications; Retrospective Studies; Statistical analysis
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2022.108378

Little is currently known about the role of lipid metabolism in diabetic kidney disease (DKD), warranting further study. The present study sought to investigate the correlation between lipid metabolism and renal function as well as renal pathological grade/score in DKD patients. A total of 224 patients diagnosed with DKD by pathological examination were retrospectively analyzed, of which 74 patients were further evaluated by DKD pathological grade/score. ANOVA was used to investigate serum lipoprotein (a) [Lp (a)] levels in DKD patients with different chronic kidney disease (CKD) stages. Spearman correlation analysis was used to evaluate the relationship between Lp (a) and renal function-related indicators. The DKD pathological grade/score was also evaluated with this method. The receiver operating characteristic (ROC) curve was used to analyze the value of Lp (a) in assessing renal function and pathological changes. There were significant differences in Lp (a) levels among different CKD stages (H = 17.063, p = 0.002) and glomerular grades (H = 12.965, p = 0.005). Lp (a) levels correlated with serum creatinine (p = 0.000), blood urea nitrogen (p = 0.000), estimated glomerular filtration rate (p = 0.000), 24-h proteinuria (24hUPro, p = 0.000), urine microalbumin (p = 0.000), urine albumin creatinine ratio (p = 0.000), glomerular basement membrane thickness (p = 0.003), and glomerular grade (p = 0.039). ROC curve demonstrated good performance of Lp (a) as an indicator to assess CKD stage 4–5 (AUC = 0.684, p = 0.000), 24hUPro > 3.5 g (AUC = 0.720, p = 0.000), and glomerular grade III-IV (AUC = 0.695, p = 0.012). Elevated levels of Lp (a) are associated with decreased GFR, increased proteinuria, and renal pathological progression, suggesting they could be used to monitor changes in DKD patients. •Serum lipoprotein (a) is associated with glomerular filtration rate and renal pathological grade in diabetic kidney disease.•Lipoprotein (a) is an indicator that reflect changes in renal function and pathology in diabetic kidney disease.•Active regulation of serum lipoprotein (a) could be prospective for the treatment of diabetic kidney disease.