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Remnant-like Particle-Cholesterol Concentrations in Patients with Type 2 Diabetes Mellitus and End-Stage Renal Disease

¹ Division of Clinical Biochemistry and Human Metabolism, Dallas, TX 75235.

² Center for Human Nutrition, and Department of Pathology and Internal Medicine, Dallas, TX 75235.

³ University of Texas Southwestern Medical Center, Dallas, TX 75235.
^a Address correspondence to this author at: Division of Clinical Biochemistry and Human Metabolism, Department of Internal Medicine and Pathology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., CS3.114, Dallas, TX 75235-9073. Fax 214-648-8037; e-mail jialal.i{at}pathology.swmed.edu

Background: Lipid abnormalities contribute significantly to the increased risk of cardiovascular disease in diabetic and end-stage renal disease (ESRD) patients. Accumulating evidence supports a proatherogenic role for remnant lipoproteins. Thus, the aim of the present study was to compare remnant-like particle-cholesterol (RLP-C) in type 2 diabetic and ESRD patients with age- and gender-matched controls.

Methods: Using an immunoaffinity assay, we measured RLP-C concentrations in 48 type 2 diabetic patients with (n = 24) and without (n = 24) macrovascular complications, and 24 age- and gender-matched controls, as well as in 38 ESRD patients on hemodialysis (n = 19) and peritoneal dialysis (n = 19), and 19 age- and gender-matched controls.

Results: RLP-C correlated significantly with plasma triglycerides (TGs; r = 0.8). When compared with controls, RLP-C concentrations were significantly higher in type 2 diabetic patients with and without macrovascular complications (median, 0.22 and 0.17 mmol/L vs 0.14 mmol/L; P <0.0002 and <0.01, respectively); diabetic patients with macrovascular complications also had significantly higher RLP-C than diabetic patients without macrovascular complications (P <0.05). However, when RLP-C/TG ratios were computed, only diabetic patients with macrovascular complications showed significantly higher RLP-C/TG ratios compared with controls (P <0.05). Regarding ESRD, RLP-C concentrations were significantly increased in patients on both hemodialysis and peritoneal dialysis compared with controls (median, 0.23 and 0.21 mmol/L vs 0.13 mmol/L; P <0.0001). Whereas RLP-C was increased in ESRD patients on hemodialysis with TGs <2.26 mmol/L compared with controls, RLP-C/TG ratios were not significantly increased in these patients.

Conclusions: Type 2 diabetic patients with macrovascular disease demonstrated increased RLP-C and RLP-C/TG ratios, whereas ESRD patients showed only increased RLP-C concentrations.

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