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

Abstract

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 investigate the serum lipid profiles in diabetic uremic patients on 10 years of maintenance hemodialysis treatment. Methods. Thirty diabetic uremic subjects and 40 age-matched nondiabetic subjects on long-term hemodialysis therapy were selected, and their clinical characteristics and serum concentrations of lipids, apolipoproteins, lecithin cholesterol acyltransferase (LCAT) activity, and apolipoprotein (apo) E phenotype were evaluated. Results. Patients with diabetic uremia had a higher prevalence of macrovascular complications, including ischemic heart diseases and cerebrovascular diseases. The mean levels of serum total cholesterol, triglyceride, and high-density lipoprotein cholesterol remained normal. Nondiabetic uremic patients exhibited a reduction in serum apo A-1, serum apo A-2, serum apo C-2, and 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, and LCAT activity. Frequencies of apo E isoforms were not significantly different between two groups of uremic patients. Conclusions. These results clearly indicate that lipid abnormalities in diabetic uremic patients on long-term hemodialysis therapy are more enhanced than those in nondiabetic uremic patients, suggesting that diabetic hemodialyzed patients are more prone to increase the individual risk for accelerated atherosclerosis to cause a higher incidence of cardiovascular diseases. © 1999 by the International Society of Nephrology.