Review

Dyslipidemia, Kidney Disease, and Cardiovascular Disease in Diabetic Patients

Szu-chi Chen¹, Chin-Hsiao Tseng^1,2,3

Manuscript submitted March 15, 2013; resubmitted May 23, 2013; accepted June 1, 2013.

Keywords: type 2 diabetes, dyslipidemia, chronic kidney disease, cardiovascular disease

Abstract

This article reviews the relationship between dyslipidemia, chronic kidney disease, and cardiovascular diseases in patients with diabetes. Diabetes mellitus is associated with complications in the cardiovascular and renal system, and is increasing in prevalence worldwide. Modification of the multifactorial risk factors, in particular dyslipidemia, has been suggested to reduce the rates of diabetes-related complications. Dyslipidemia in diabetes is a condition that includes hypertriglyceridemia, low high-density lipoprotein levels, and increased small and dense low-density lipoprotein particles. This condition is associated with higher cardiovascular risk and mortality in diabetic patients. Current treatment guidelines focus on lowering the low-density lipoprotein cholesterol level; multiple trials have confirmed the cardiovascular benefits of treatment with statins. Chronic kidney disease also contributes to dyslipidemia, and dyslipidemia in turn is related to the occurrence and progression of diabetic nephropathy. Different patterns of dyslipidemia are associated with different stages of diabetic nephropathy. Some trials have shown that treatment with statins not only decreased the risk of cardiovascular events, but also delayed the progression of diabetic nephropathy. However, studies using statins as the sole treatment of hyperlipidemia in patients on dialysis have not shown benefits with respect to cardiovascular risk. Diabetic patients with nephropathy have a higher risk of cardiovascular events than those without nephropathy. The degree of albuminuria and the reduction in estimated glomerular filtration rate are also correlated with the risk of cardiovascular events. Treatment with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers to reduce albuminuria in diabetic patients has been shown to decrease the risk of cardiovascular morbidity and mortality.

Fulltext: HTML , PDF (171KB)

This article has been cited by other articles:

	'Adipaging': ageing and obesity share biological hallmarks related to a dysfunctional adipose tissue Perez LM, Pareja-Galeano H, Sanchis-Gomar F, Emanuele E, Lucia A, Galvez BG J Physiol 2016. 594(12):3187-207
	Greater efficacy of atorvastatin versus a non-statin lipid-lowering agent against renal injury: potential role as a histone deacetylase inhibitor Singh RS, Chaudhary DK, Mohan A, Kumar P, Chaturvedi CP, Ecelbarger CM, Godbole MM, Tiwari S Sci Rep 2016. 6:38034
	Role of Patient and Practice Characteristics in Variance of Treatment Quality in Type 2 Diabetes between General Practices Cho YY, Sidorenkov G, Denig P Plos One 2016. 11(11):e0166012
	Effect of edaravone in diabetes mellitus-induced nephropathy in rats Varatharajan R, Lim LX, Tan K, Tay CS, Teoh YL, Akhtar SS, Rupeshkumar M, Chung I, Abdullah NA, Banik U, Dhanaraj SA, Balakumar P Korean J Physiol Pharmacol 2016. 20(4):333-340
	The Effect of Dietary Supplementation With Curcumin on Redox Status and Nrf2 Activation in Patients With Nondiabetic or Diabetic Proteinuric Chronic Kidney Disease: A Pilot Study Jimenez-Osorio AS, Garcia-Nino WR, Gonzalez-Reyes S, Alvarez-Mejia AE, Guerra-Leon S, Salazar-Segovia J, Falcon I, Montes de Oca-Solano H, Madero M, Pedraza-Chaverri J J Ren Nutr 2016. 26(4):237-244
	Effect of breviscapine injection on clinical parameters in diabetic nephropathy: A meta-analysis of randomized controlled trials Liu X, Yao L, Sun D, Zhu X, Liu Q, Xu T, Wang L Exp Ther Med 2016. 12(3):1383-1397
	The diabetogenic action of statins - mechanisms and clinical implications Betteridge DJ, Carmena R Nat Rev Endocrinol 2016. 12(2):99-110
	Heart Rate Variability as Early Biomarker for the Evaluation of Diabetes Mellitus Progress Arroyo-Carmona RE, Lopez-Serrano AL, Albarado-Ibanez A, Mendoza-Lucero FM, Medel-Cajica D, Lopez-Mayorga RM, Torres-Jacome J J Diabetes Res 2016. 2016:8483537
	Serum Oxidized LDL Levels in Type 2 Diabetic Patients with Retinopathy in Mthatha Region of the Eastern Cape Province of South Africa Ganjifrockwala F, Joseph J, George G Oxid Med Cell Longev 2016. 2016:2063103
	Association between Hyperglycemia, C-Reactive Protein and Other Risk Factors in Patients at Cardiovascular Risk Barbalho SM, Toffano RJ, Bechara MD, Quesada KR, Oshiiwa M, Mendes CG, Gabaldi MR J Diabetes Melli 2016. 6(1):16-24
	Heart rate variability in type 1 diabetes mellitus patients Sugantha MJ, Balasubramanian K, Rathnavelkumaran M, Muralikrishnan K Ind J Basic Appl Med Res 2016. 6(1):624-633
	Decreased total antioxidant levels and increased oxidative stress in South African type 2 diabetes mellitus patients Ganjifrockwala FA, Joseph JT, George G J Endocrinol Metab Diabetes South Afr 2016. 1(1):1-5
	The changes in miR-130b levels in human serum and the correlation with the severity of diabetic nephropathy Lv C, Zhou YH, Wu C, Shao Y, Lu CL, Wang QY Diabetes Metab Res Rev 2015. 31(7):717-724
	Increasing body mass index identifies Chinese patients with type 2 diabetes mellitus at risk of poor outcomes Ji L, Zou D, Liu L, Qian L, Kadziola Z, Babineaux S, Zhang HN, Wood R J Diabetes Complications 2015. In press
	Targeted Lipidomic and Transcriptomic Analysis Identifies Dysregulated Renal Ceramide Metabolism in a Mouse Model of Diabetic Kidney Disease Sas KM, Nair V, Byun J, Kayampilly P, Zhang H, Saha J, Brosius FC 3rd, Kretzler M, Pennathur S J Proteomics Bioinform 2015. Suppl 14:002
	Cobrotoxin from Naja naja atra Venom Ameliorates Adriamycin Nephropathy in Rats Wang SZ, Xu YL, Zhu Q, Kou JQ, Qin ZH Evid Based Complement Alternat Med 2015. 2015:450581
	Rosuvastatin attenuates contrast-induced nephropathy through modulation of nitric oxide, inflammatory responses, oxidative stress and apoptosis in diabetic male rats Deng J, Wu G, Yang C, Li Y, Jing Q, Han Y J Transl Med 2015. 13(1):53
	Chlorophytum borivilianum root extract maintains near normal blood glucose, insulin and lipid profile levels and prevents oxidative stress in the pancreas of streptozotocin-induced adult male diabetic rats Giribabu N, Kumar KE, Rekha SS, Muniandy S, Salleh N Int J Med Sci 2014. 11(11):1172-1184
	Risks of rapid decline renal function in patients with type 2 diabetes Sheen YJ, Sheu WH World J Diabetes 2014. 5(6):835-846
	A smart web aid for preventing diabetes in rural China: preliminary findings and lessons Chen P, Chai J, Cheng J, Li K, Xie S, Liang H, Shen X, Feng R, Wang D J Med Internet Res 2014. 16(4):e98
	Alternative Medicine in Diabetes - Role of Angiogenesis, Oxidative Stress, and Chronic Inflammation El-Refaei MF, Abduljawad SH, Alghamdi AH Rev Diabet Stud 2014. 11(3-4):231-244
	Renoprotective effect of atorvastatin on STZ-diabetic rats through attenuating kidney-associated dysmetabolism Zhou S, Zhao P, Li Y, Deng T, Tian L, Li H Eur J Pharmacol 2014. 740:9-14