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Article: Carbamylated Lipoproteins and Progression of Diabetic Kidney Disease

TitleCarbamylated Lipoproteins and Progression of Diabetic Kidney Disease
Authors
Keywordsdiabetic nephropathy
progression of renal failure
humans
diabetic nephropathies
glomerular filtration rate
Issue Date2020
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.cjasn.org
Citation
Clinical Journal of the American Society of Nephrology, 2020, v. 15 n. 3, p. 359-366 How to Cite?
AbstractBackground and objectives: Protein carbamylation is a consequence of uremia and carbamylated lipoproteins contribute to atherogenesis in CKD. Proteins can also be carbamylated by a urea-independent mechanism, and whether carbamylated lipoproteins contribute to the progression of CKD has not been investigated. Design, setting, participants, & measurements: A case-control study was performed to determine whether there were changes in plasma levels of carbamylated lipoproteins in individuals with type 2 diabetes with eGFR >60 ml/min per 1.73 m2 compared with a group of age- and sex-matched healthy controls. A cohort of 1320 patients with type 2 diabetes with baseline eGFR ≥30 ml/min per 1.73 m2 was longitudinally followed up to evaluate the association between carbamylated lipoproteins and progression of CKD. The primary kidney outcome was defined as doubling of serum creatinine and/or initiation of KRT during follow-up. Plasma carbamylated LDLs and HDLs was measured by ELISA. Results: In individuals with diabetes with eGFR >60 ml/min per 1.73 m2, both plasma carbamylated LDL and HDL levels were higher compared with healthy controls (P<0.001). After a mean follow-up of 9 years of the diabetic cohort, individuals in the top quartile of carbamylated LDL (hazard ratio, 2.21; 95% confidence interval, 1.42 to 3.46; P<0.001) and carbamylated HDL (hazard ratio, 4.53; 95% confidence interval, 2.87 to 7.13; P<0.001) had higher risk of deterioration of kidney function compared with those in the lowest quartile. On multivariable Cox regression analysis, plasma carbamylated LDL was no longer associated with kidney outcome after adjusting for baseline eGFR and potential confounding factors. However, the association between plasma carbamylated HDL and kidney outcome remained significant and was independent of HDL cholesterol. Conclusions: Plasma carbamylated HDL but not carbamylated LDL was independently associated with progression of CKD in patients with type 2 diabetes.
Persistent Identifierhttp://hdl.handle.net/10722/282271
ISSN
2019 Impact Factor: 6.628
2015 SCImago Journal Rankings: 2.534
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTan, KCB-
dc.contributor.authorCheung, C-L-
dc.contributor.authorLee, ACH-
dc.contributor.authorLam, JKY-
dc.contributor.authorWong, Y-
dc.contributor.authorShiu, SWM-
dc.date.accessioned2020-05-05T14:32:58Z-
dc.date.available2020-05-05T14:32:58Z-
dc.date.issued2020-
dc.identifier.citationClinical Journal of the American Society of Nephrology, 2020, v. 15 n. 3, p. 359-366-
dc.identifier.issn1555-9041-
dc.identifier.urihttp://hdl.handle.net/10722/282271-
dc.description.abstractBackground and objectives: Protein carbamylation is a consequence of uremia and carbamylated lipoproteins contribute to atherogenesis in CKD. Proteins can also be carbamylated by a urea-independent mechanism, and whether carbamylated lipoproteins contribute to the progression of CKD has not been investigated. Design, setting, participants, & measurements: A case-control study was performed to determine whether there were changes in plasma levels of carbamylated lipoproteins in individuals with type 2 diabetes with eGFR >60 ml/min per 1.73 m2 compared with a group of age- and sex-matched healthy controls. A cohort of 1320 patients with type 2 diabetes with baseline eGFR ≥30 ml/min per 1.73 m2 was longitudinally followed up to evaluate the association between carbamylated lipoproteins and progression of CKD. The primary kidney outcome was defined as doubling of serum creatinine and/or initiation of KRT during follow-up. Plasma carbamylated LDLs and HDLs was measured by ELISA. Results: In individuals with diabetes with eGFR >60 ml/min per 1.73 m2, both plasma carbamylated LDL and HDL levels were higher compared with healthy controls (P<0.001). After a mean follow-up of 9 years of the diabetic cohort, individuals in the top quartile of carbamylated LDL (hazard ratio, 2.21; 95% confidence interval, 1.42 to 3.46; P<0.001) and carbamylated HDL (hazard ratio, 4.53; 95% confidence interval, 2.87 to 7.13; P<0.001) had higher risk of deterioration of kidney function compared with those in the lowest quartile. On multivariable Cox regression analysis, plasma carbamylated LDL was no longer associated with kidney outcome after adjusting for baseline eGFR and potential confounding factors. However, the association between plasma carbamylated HDL and kidney outcome remained significant and was independent of HDL cholesterol. Conclusions: Plasma carbamylated HDL but not carbamylated LDL was independently associated with progression of CKD in patients with type 2 diabetes.-
dc.languageeng-
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at http://www.cjasn.org-
dc.relation.ispartofClinical Journal of the American Society of Nephrology-
dc.subjectdiabetic nephropathy-
dc.subjectprogression of renal failure-
dc.subjecthumans-
dc.subjectdiabetic nephropathies-
dc.subjectglomerular filtration rate-
dc.titleCarbamylated Lipoproteins and Progression of Diabetic Kidney Disease-
dc.typeArticle-
dc.identifier.emailTan, KCB: kcbtan@hkucc.hku.hk-
dc.identifier.emailCheung, C-L: lung1212@hku.hk-
dc.identifier.emailLee, ACH: achlee@hku.hk-
dc.identifier.emailLam, JKY: lamkyj@hku.hk-
dc.identifier.emailWong, Y: ywong@hku.hk-
dc.identifier.emailShiu, SWM: swmshiu@hku.hk-
dc.identifier.authorityTan, KCB=rp00402-
dc.identifier.authorityCheung, C-L=rp01749-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.2215/CJN.11710919-
dc.identifier.pmid32075807-
dc.identifier.pmcidPMC7057307-
dc.identifier.scopuseid_2-s2.0-85081944353-
dc.identifier.hkuros309807-
dc.identifier.volume15-
dc.identifier.issue3-
dc.identifier.spage359-
dc.identifier.epage366-
dc.identifier.isiWOS:000525580900011-
dc.publisher.placeUnited States-
dc.identifier.issnl1555-9041-

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