Sphingomyelin is associated with kidney disease in type 1 diabetes (The FinnDiane Study) |
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Authors: | Ville-Petteri M?kinen Tuulia Tynkkynen Pasi Soininen Carol Forsblom Tomi Peltola Antti J Kangas Per-Henrik Groop Mika Ala-Korpela |
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Institution: | 1. Computational Medicine Research Group, Institute of Clinical Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, 90014, Oulu, Finland 2. Department of Internal Medicine and Biocenter Oulu, Clinical Research Center, University of Oulu, Oulu, Finland 3. NMR Metabonomics Laboratory, Department of Biosciences, University of Eastern Finland, Kuopio, Finland 4. Folkh?lsan Research Center, Folkh?lsan Institute of Genetics, Biomedicum, Helsinki, Finland 5. Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland 6. Department of Biomedical Engineering and Computational Science, School of Science and Technology, Aalto University, Helsinki, Finland
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Abstract: | Diabetic kidney disease, diagnosed by urinary albumin excretion rate (AER), is a critical symptom of chronic vascular injury in diabetes, and is associated with dyslipidemia and increased mortality. We investigated serum lipids in 326 subjects with type 1 diabetes: 56% of patients had normal AER, 17% had microalbuminuria (20?≤?AER?200?μg/min or 30?≤?AER?300?mg/24?h) and 26% had overt kidney disease (macroalbuminuria AER?≥?200?μg/min or AER?≥?300?mg/24?h). Lipoprotein subclass lipids and low-molecular-weight metabolites were quantified from native serum, and individual lipid species from the lipid extract of the native sample, using a proton NMR metabonomics platform. Sphingomyelin (odds ratio 2.53, P?10(-7)), large VLDL cholesterol (odds ratio 2.36, P?10(-10)), total triglycerides (odds ratio 1.88, P?10(-6)), omega-9 and saturated fatty acids (odds ratio 1.82, P?10(-5)), glucose disposal rate (odds ratio 0.44, P?10(-9)), large HDL cholesterol (odds ratio 0.39, P?10(-9)) and glomerular filtration rate (odds ratio 0.19, P?10(-10)) were associated with kidney disease. No associations were found for polyunsaturated fatty acids or phospholipids. Sphingomyelin was a significant regressor of urinary albumin (P?0.0001) in multivariate analysis with kidney function, glycemic control, body mass, blood pressure, triglycerides and HDL cholesterol. Kidney injury, sphingolipids and excess fatty acids have been linked in animal models-our exploratory approach provides independent support for this relationship in human patients with diabetes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11306-011-0343-y) contains supplementary material, which is available to authorized users. |
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