Plasma ApoM levels and Progression to Kidney Dysfunction in Type 1 Diabetics

  

Apolipoprotein M (apoM), primarily carried by HDL, has been associated with several conditions including cardiovascular disease and diabetic nephropathy. This study proposes to examine whether plasma apoM levels are associated with the development of diabetic kidney disease, assessed as progression to macroalbuminuira and chronic kidney disease.

Plasma apoM was measured using an enzyme immunoassay in 386 subjects from the DCCT/EDIC cohort at DCCT entry and closeout and the concentrations used to determine the association with risk of progression to kidney dysfunction from the time of measurement through 18 years of EDIC follow-up. 

ApoM levels, at DCCT baseline, were higher in patients who developed CKD than in those who retained normal renal function. At DCCT closeout, participants who progressed to MA, CKD or both MA and CKD had also significantly higher apoM levels than those who remained normal and increased levels of apoM were associated with increased risk of progression to both MA [RR=1.30 (95% CI=1.01,1.66)] and CKD [RR=1.69 (95% CI=1.18,2.44)].

Our results strongly suggest that alterations in Apo M and therefore in the composition and function of HDL in type 1 diabetes is present early in the disease process and it is associated with the development of nephropathy.