Remarkable increase of apolipoprotein B48 level in diabetic patients with end-stage renal disease

• Published in: Atherosclerosis Vol. 197; no. 1; pp. 154 - 158
• Main Authors: Hayashi, Toshiyuki, Hirano, Tsutomu, Taira, Takayasu, Tokuno, Anna, Mori, Yusaku, Koba, Shinji, Adachi, Mitsuru
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.03.2008; Elsevier
• Subjects: Aged; Albuminuria - epidemiology; Albuminuria - metabolism; Apolipoprotein B-48 - blood; Apolipoprotein B48; Associated diseases and complications; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Chylomicrons - metabolism; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - metabolism; Diabetes. Impaired glucose tolerance; Diabetic Nephropathies - epidemiology; Diabetic Nephropathies - metabolism; Diabetic nephropathy; Dyslipidemia; Dyslipidemias - epidemiology; Dyslipidemias - metabolism; End-stage renal disease; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Kidney Failure, Chronic - blood; Male; Medical sciences; Middle Aged; Risk Factors; End-stage renal disease; Diabetic nephropathy; Apolipoprotein B48; Dyslipidemia; Endocrinopathy; Kidney disease; Human; Urinary system disease; Chronic renal failure; Diabetes mellitus; Metabolic diseases; Lipids; Cardiovascular disease; Apolipoprotein; Vascular disease; Concomitant disease; Atherosclerosis; Dyslipemia
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2007.03.015

Abstract Apolipoprotein (apo) B48 is a structural protein of chylomicrons. Fasting serum levels of apoB48 suggest the presence of small number of remnant chylomicron particles which are thought to be an atherogenic lipoprotein. In view of the high incidence of coronary heart disease (CHD) in patients with diabetic nephropathy, we decided to measure the plasma apoB48 level in type 2 diabetics with diabetic nephropathy at various stages to ascertain how apoB48 relates to the progression of diabetic nephropathy. Patients with type 2 diabetes ( n = 105) were stratified into four groups: normo-albuminuria, micro-albuminuria, overt-proteinuria, and patients with end-stage renal disease (ESRD) receiving hemodialysis. Age-matched-diabetic hypertensive patients ( n = 24) and non-diabetic ESRD patients on hemodialysis ( n = 47) were also enrolled. Plasma triglyceride (TG) levels rose as diabetic nephropathy progressed to overt-proteinuria. No further elevation in TG was observed in diabetic ESRD, however, and the TG levels were normal in non-diabetic ESRD. A similar pattern was observed for remnant-like particle-cholesterol (RLP-C). In contrast to the changes observed for TG and RLP-C, the levels of apoB48 increased steadily as the diabetic nephropathy progressed (control, 3.7; normo, 5.7; micro, 6.9; overt, 10.6 mg/l, respectively). ApoB48 peaked in the diabetic ESRD (19 mg/l) and was also markedly elevated in non-diabetic ESRD (10.1 mg/l). The apoB48/TG and apoB48/total-apoB ratios were substantially elevated in both diabetic and non-diabetic ESRD. These results are the first to demonstrate remarkable elevations of plasma apoB48 in patients with both diabetic and non-diabetic ESRD. The remarkably high level of apoB48 in diabetic ESRD seems to be attributable to dyslipidemia induced by both diabetic nephropathy and ESRD.