Category: Lipids/CV Health

Monitor: 33

33 - THE ASSOCIATION OF LIPID ABNORMALITIES AND MICROALBUMINURIA IN TYPE 2 DIABETICS AS A MARKER FOR OPTIMAL CARE-- REAL WORLD PERSPECTIVES

Thursday, Apr 25
11:30 AM – 12:00 PM

Objective :

Microalbuminuria is an indicator of the incipient phase of diabetic nephropathy in diabetes mellitus. The associated lipid abnormalities increase the risk for the cardiovascular events multifold. There is limited data from the real-world setting for the independent markers that would predict the existence and the degree of microalbuminuria.


Methods :

We retrospectively analysed the data from the North Delhi Diabetes Centre (NDDC) cohort of 3382 T2DM patients for last 5 years, who were treated on a guideline directed- standard care of approach. Sub-group of 1250 patients were identified with microalbumin threshold of 300 mcg/mg creatinine to investigate the relationship between the presence of lipid abnormalities and microalbuminuria.  The groups were categorised as Microalbuminuria Group (MG) (n=260) and Non- Microalbuminuria Group (NMG) (n=990) for association with LDL-C, HDL-C and LDL/HDL-C ratio. Mann Whitney test was utilised for the statistical analysis.


Results :

Microalbuminuria (30-300 mcg/mg creatinine) was prevalent in 26.2% (260/990) of T2DM patients. The mean HbA1c in the sub-group (n=1250) was 8.72 ±1.85%. The Low Density Lipoprotein Cholesterol (LDL-C) in MG and NMG were (mean ± SD, 95% CI) 82.27 ± 26.08, 95% CI 79.08 to 85.46 and 88.5 ± 29.05, 95% CI 86.69 to 90.32, respectively (p= 0.0017 significant). The High Density Lipoprotein Cholesterol (HDL-C) in MG and NMG were (mean ± SD, 95% CI) 49.64 ± 2.2, 95% CI 49.37 to 49.91 and 49.83 ± 2.41, 95% CI 49.68 to 49.98, respectively (p= 0.30 NS). The LDL/HDL ratio in MG and NMG were (mean ± SD, 95% CI) 1.66 ± 0.55, 95% CI 1.59 to 1.73 and 1.78 ± 0.61, 95% CI 1.74 to 1.82, respectively (p= 0.0047 significant). LDL-C and the LDL/HDL-C ratio in NMG were significantly higher than those in MG.


Discussion :

The inverse relationship for the association of the lower levels of LDL-C and LDL/HDL-C ratio in microalbuminuria group could be due to the aggressive therapeutic and care, including statins received by this group. Monitoring of LDL/HDL-C ratio would identify the patients for early treatment of microalbuminuria that can prevent or postpone overt nephropathy.


Conclusion :

The correlation between lipid parameters and microalbuminuria implies that dyslipidemia is associated with early signals of renal insufficiency. Therapeutic strategies should be optimally designed for prevention and reduction of microalbuminuria and reduce the risk of cardiovascular events.

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Siddhant Trehan

SR MEDICAL OFFICER
PEDIATRIC CARDIAC INTENSIVE CARE ARTEMIS HOSPITAL GURUGRAM, India

SR MEDICAL OFFICER PEDIATRIC CARDIAC INTENSIVE CARE ARTEMIS HOSPITAL GURUGRAM

Shalini Jaggi

Head
Dr V Mohan's Centre, Delhi

North Delhi Diabetic Centre

Shalini Jaggi

Head
Dr V Mohan's Centre, Delhi

Senior Diabetologist

Aastha Chawla

MD RESIDENT DEPT OF DERMATOLOGY
S P MEDICAL COLLEGE BIKANER, India

MD RESIDENT DEPT OF DERMATOLOGY S P MEDICAL COLLEGE BIKANER

Vinay Kumar

FELLOW DIABETES
North Delhi Diabetes Centre
New Delhi, India

FELLOW DIABETES North Delhi Diabetes Centre

BRIJ MOHAN Makkar

SENIOR DIABETOLOGIST AND DIRECTOR
DR MAKKAR OBESITY AND DIABETES CENTRE, India

SENIOR DIABETOLOGIST AND DIRECTOR DR MAKKAR OBESITY AND DIABETES CENTRE