The relationship between serum lipid levels and diabetic nephropathy in patients with primary diabetes

Abstract

Background: Diabetic nephropathy (DN) is a severe complication of diabetes. Patients with diabetes often have abnormal blood lipid levels, although evidence of correlations between serum lipid concentrations and DN is still insufficient. The aim of this study was to examine the correlation between blood lipid levels and DN in order to provide information to improve the diagnosis and treatment of DN. Methods: Patients with primary types 1 and 2 diabetes in the MIMIC-Ⅳ database were selected as the study population, with the outcome event being DN. The patients were grouped according to quartiles based on the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG). A logistic regression model was constructed to examine the correlation between blood lipid levels and DN. The regression model was adjusted for different confounding factors to verify the stability of the results, with interactions and subgroup analysis also conducted. Results: A total of 15,431 patients with primary types 1 and 2 diabetes were enrolled in this study, including 2,092 (13.56%) patients with DN. The results of the multivariate logistic regression indicated that high levels of TC (OR, 1.241; 95%CI, 1.054–1.460) and TG (OR, 1.187; 95%CI, 1.019–1.383) correlated positively with the occurrence of DN, whereas the correlation between increased levels of HDL-C and LDL-C and DN occurrence was not statistically significant. The present study also observed an interaction of TC levels with gender and estimated glomerular filtration rate (eGFR). Conclusion: This study showed that abnormal concentrations of TC and TG correlated positively with the occurrence of DN in patients with primary diabetes. This finding emphasizes the importance of regulating blood lipids, and to some extent provided a reference value for selection of lipid-modulating drugs in patients with DN. Clinical trial number: No trial number as this is not a clinical trial.