We aimed to examine the relationship of serum lipids, lipoproteins, apolipoproteins and antioxidants with renal dysfunction as measured by urinary excretion of albumin and of retinol binding protein (REP) in insulin-dependent diabetes mellitus (IDDM). We studied 121 patients with IDDM. Glomerular function was assessed as the urinary albumin/creatinine ratio (U-A/U-C), and tubular function as the urinary retinol-binding protein/creatinine ratio (U-R/U-C), both measured in three early morning spot urine samples. The mean (range) U-A/U-C was 1.95 mg/mmol (0.3-476.5) and U-R/U-C was 17.5 mu g/mmol (1.0-1853.8). 17% of the patients had a U-A/U-C > 3 mg/mmol and 33% had a U-R/U-C > 20 mu g/mmol. Significant positive 'correlations were observed between both U-A/U-C and U-R/U-C and the following: serum total cholesterol (P <0.005); triglycerides(P <0.001); apolipoproteins A-I (P <0.05), A-II (P <0.02) and B (P <0.002); glycated haemoglobin (P <0.002). No significant associations were found with serum vitamin E, beta-carotene or total antioxidant activity. In multiple regression, only U-A/U-C was independently associated with serum apo B and cholesterol concentrations. In conclusion, in IDDM glomerular dysfunction, as measured by U-A/U-C, is associated with elevated serum cholesterol, triglycerides, apo B, apo A-I and apo A-II, but not with HDL cholesterol or antioxidant status. Tubular dysfunction tends to occur with increasing albuminuria, but it is not independently associated with serum lipid, lipoprotein, apolipoprotein or antioxidant levels.
O'Brien, S. F., Watts, G., Powrie, J. K., Shaw, K. M., & Miller, N. J. (1996). Lipids, lipoproteins, antioxidants and glomerular and tubular dysfunction in type 1 diabetes. Diabetes Research and Clinical Practice, 32(N/A), 81-90. https://doi.org/10.1016/0168-8227(96)01252-1