Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Diabetes Care 29:1176-1177, 2006
DOI: 10.2337/dc06-0264
© 2006 by the American Diabetes Association
This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wierusz-Wysocka, B.
Right arrow Articles by Pisarczyk-Wiza, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wierusz-Wysocka, B.
Right arrow Articles by Pisarczyk-Wiza, D.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Letters: Observations

Higher Levels of HDL Cholesterol Are Associated With a Decreased Likelihood of Albuminuria in Patients With Long-Standing Type 1 Diabetes

Response to Molitch et al.

Bogna Wierusz-Wysocka, MD, Dorota A. Zozulinska, MD, Aleksandra Araszkiewicz, MD and Dorota Pisarczyk-Wiza, MD

From the Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland

Address correspondence to Assist. Prof. Dorota Zozulinska, Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland. E-mail: zozula{at}box43.pl

We read with great interest the article by Molitch et al. (1), concerning the association between high levels of HDL cholesterol and albuminuria in type 1 diabetes. We have found similar results in a group of 157 patients with long-standing type 1 diabetes but in relation to retinopathy, which seems to be a more objective marker of microangiopathy than albuminuria in diabetes. Retinopathy was assessed by two experienced ophthalmologists using direct ophthalmoscopy on dilated pupils, followed, if necessary, by fluorescein angiography. Pictures of the eye fundus were collected. We divided our patients into two groups, one with (n = 118) and one without (n = 39) retinopathy. Two assessed groups were identical with respect to age (42.3 ± 12.6 vs. 39.9 ± 12.5 years, P > 0.05) and duration of diabetes (26.5 ± 6.9 vs. 25.7 ± 6.5 years, P > 0.05). Similarly to Molitch et al. (1), HDL cholesterol levels were significantly lower in patients with diabetic retinopathy than in those that did not have any changes at fundus of the eye (1.49 ± 0.4 vs. 1.65 ± 0.42 mmol/l, P = 0.039). Higher levels of HDL cholesterol (≥1.6 vs. <1.6 mmol/l) were associated with a five-times–lower likelihood of diabetic retinopathy (OR 0.20 [95% CI 0.06–0.70], P = 0.01). Of patients with retinopathy, 55% had positive microalbuminuria. However, the majority of patients with retinopathy were treated with ACE inhibitors, which must have influenced this percentage.

Contrary to Molitch et al. (1), we have not found any differences in HbA1c between patients with and without retinopathy (8.2 ± 1.4 vs. 8.1 ± 1.3%, P > 0.5). Our study suggests that high HDL cholesterol may, independently of glycemic control, prevent the development of microvascular complications in type 1 diabetes. These results could be related to antioxidant, antithrombotic, and anti-inflammatory properties of HDL particles (2). Interestingly, structural modifications of HDL mediated by various mechanisms, including glycation, oxidation, and enzymatic degradation, may affect their functional and atheroprotective properties (3). This may suggest that not only quantity but also quality of HDL particles play a role in the damage of endothelium.

Molitch et al. (1) and our studies confirm the hypothesis that the higher the levels of HDL cholesterol, the lower the risk of late diabetes complications.

References

  1. Molitch ME, Rupp D, Carnethon M: Higher levels of HDL cholesterol are associated with a decreased likelihood of albuminuria in patients with long-standing type 1 diabetes. Diabetes Care29 :78 –82,2006[Abstract/Free Full Text]
  2. O’Connell BJ, Genest J: High-density lipoproteins and endothelial function. Circulation104 :1978 –1983,2001[Abstract/Free Full Text]
  3. Ferretti G, Bacchwtti T, Negre-Salvayre A, Salvayre R, Dousset N, Curatola G: Structural modifications of HDL and functional consequences. Atherosclerosis183 :1 –7,2006

Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wierusz-Wysocka, B.
Right arrow Articles by Pisarczyk-Wiza, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wierusz-Wysocka, B.
Right arrow Articles by Pisarczyk-Wiza, D.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum