Diabetes Res Clin Pract. 2026 Sep 28:113571. doi: 10.1016/j.diabres.2026.113571. Online ahead of print.
ABSTRACT
AIMS: Patients with type 2 diabetes mellitus (T2DM) commonly exhibit atherogenic dyslipidemia and increased oxidative stress, which may contribute to the development and progression of diabetic kidney disease (DKD). We investigated the associations of intermediate-density lipoprotein cholesterol (IDL-C) and α-tocopherol in low-density lipoprotein (LDL-α-tocopherol) with renal dysfunction in T2DM.
METHODS: A total of 188 outpatients with T2DM were categorized into tertiles according to estimated glomerular filtration rate (eGFR). Lipoprotein fractions (HDL-, LDL-, IDL-, and VLDL-cholesterol) and LDL-α-tocopherol content were quantified using anion-exchange high-performance liquid chromatography. Arterial stiffness was assessed by brachial-ankle pulse wave velocity. Multivariable analyses were performed to evaluate associations between eGFR, lipoprotein parameters, and lipid-lowering therapy.
RESULTS: Declining eGFR was associated with longer diabetes duration and increased arterial stiffness. IDL-C levels and the LDL-α-tocopherol/LDL-C ratio increased significantly across decreasing eGFR tertiles, whereas LDL-C levels showed a decreasing trend. eGFR was independently and inversely correlated with IDL-C and the LDL-α-tocopherol/LDL-C ratio. Statin or fibrate therapy was associated with lower IDL-C levels and higher LDL-α-tocopherol/LDL-C ratios.
CONCLUSIONS: In patients with T2DM, declining DKD is associated with atherogenic IDL accumulation and increased LDL α-tocopherol content, suggesting altered lipoprotein metabolism that may influence LDL oxidation and cardiovascular risk.
PMID:42805441 | DOI:10.1016/j.diabres.2026.113571