Scientists in Australia have revealed that type 2 diabetes patients with lower levels of high-density lipoprotein (HDL or ‘good’) cholesterol are more likely to develop diabetic nephropathy, also known as diabetic kidney disease.
Jamie Morto, of The Heart Research Institute in Sydney, and colleagues followed over 11,000 patients in the Action in Diabetes and Vascular Disease study for a period of five years. Each patient had type 2 diabetes and at least one additional risk factor for microvascular disease (damage to the small blood vessels).
They found that 34 per cent of patients developed microvascular disease over the five years, with 28 per cent experiencing a renal event (kidney problem) and 6 per cent having a retinal event (eye complication).
Patients with the lowest levels of HDL cholesterol had a 17 per cent greater risk of microvascular disease, compared to those with the highest HDL levels.
The risk of nephropathy or kidney problems was 19 per cent higher among those in the low HDL group, but there was no increased risk of diabetic retinopathy or other eye conditions compared to those with high amounts of good cholesterol, indicating that low levels of HDL raises the risk of nephropathy but not retinopathy in diabetics .
“In a large population of patients with type 2 diabetes and after adjustment for a wide variety of confounders, low HDL-C was shown to be an independent risk factor for the development and progression of microvascular disease affecting the kidney but not the retina,” the authors concluded.
“Measurement of this lipid fraction may be useful in tailoring screening and therapeutic strategies.”
The research was published online in the latest edition of the Diabetes Care journal.

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